Earlier this year, Missouri became the 39th state to expand Medicaid coverage, providing access to affordable health care to more than 200,000 newly eligible adults. Kansas is now completely landlocked by states that have decided to adopt and implement Medicaid expansion. In neighboring states, expanded coverage and eligibility requirements have made better quality health care more accessible to more people. As for the majority of Kansans, they say – it’s our turn.
Barriers to health care, including high costs of insurance, have kept necessary care out of reach for many. Fear of high hospital bills keeps people from seeking care until it’s absolutely necessary, increasing not only emergency room visits but also preventable injuries, illnesses, and deaths. Affordable health insurance allows individuals to invest in their health, allowing patients and providers to develop a cost-effective, high-quality continuum of care.
Recently, more than 160 community leaders came together to discuss the need to expand Medicaid in Kansas. “Business, Faith, Health: Why Medicaid Expansion is Right for Kansas” explored the justifications for Medicaid expansion not only from a health and economic perspective, but from a place of faith and compassion as well.
The panel of speakers featured Joe Reardon, president and CEO of the Greater Kansas City Chamber of Commerce, Reverend Dr. Nanette Roberts, senior pastor of Grace United Methodist Church in Olathe, and Dr. Robert Simari, executive vice chancellor of the University of Kansas Medical Center.
Improving Public Health
Dr. Simari began by highlighting the effect that social determinants of health can have on a person’s wellbeing, regardless of the quality of care being given by their providers. The result is disproportionate health statuses across communities, with life expectancies changing just by crossing a block. To combat this, he believes the solution is a coordinated payer system that works to eliminate some of the barriers keeping people from accessing and investing in routine care.
“It’s estimated that Medicaid expansion in Kansas would cover about 165,000 Kansans, with two-thirds of those working full-time,” he said. “For those individuals who are uninsured or under-insured, they’re going to get sick at a higher rate than if they have preventative or maintenance care, and they’re going to receive care in emergency rooms or other health care settings that may be too late and too expensive. There’s a lot of suffering that takes place to that individual before they receive care, and it’s going to cost somebody something.”
According to Dr. Simari, about 40 million dollars a year goes to providing uncovered care in the Kansas health system – care that’s ultimately late and not as effective. While urban hospitals may be able to bear the cost, rural Kansas hospitals often cannot, resulting in closures that leave a profound impact on the surrounding communities.
Rural Kansas hospitals support the economy of the towns they serve. Four hospitals have closed in recent years and according to the discussion, another 48 hospitals are at risk of closing. In rural areas, where food and transportation deserts already greatly affect community and individual health, the lack of affordable insurance and especially hospitals leaves residents without access to preventive care and emergency services.
Hospital closures also affect jobs, livelihoods, and the economy. The matter of cost is especially important, as Dr. Simari pointed out, because while Kansas taxpayers pay for expanded Medicaid in other states, they aren’t receiving the benefits themselves. “Whether you’re the individual who would benefit from gaining insurance, the doctor who’s providing care, the community of the hospital who is providing that unpaid-for care, or just a citizen who cares about what happens to your taxes – this is important,” he said.
Improving the Economy
From a business standpoint, Reardon believes that expanding Medicaid will support the Kansas economy and businesses, especially small businesses. “Everyone knows both in urban areas and in small towns in Kansas, those small businesses are the backbone, and Medicaid expansion will greatly benefit those small businesses,” he said. “Many of them are unable to provide insurance in their current state, and it’s certainly not the coverage that larger firms are able to provide.”
According to Reardon, it’s estimated that 29,000 Kansans would switch from employer-sponsored insurance to Medicaid, saving small businesses the trouble of providing upwards of $40-81 million in health insurance annually. The result would be billions of federal dollars flowing into the Kansas economy, coupled with an estimated 13,000 jobs throughout the state.
Other states that have expanded Medicaid have seen this economic boost as well as significant gains in insurance coverage for small business owners, employees, and the self-employed. These states have also seen improvements in health and workers’ ability to work with minimal impacts to the labor market. “As we’re emerging from COVID-19 and all the issues around trying to find employees, let alone keeping employees healthy and at work, this issue is paramount right now,” Reardon said.
Improving Accessibility for All
On the matter of faith, the decision is simple: access to health care is a basic human right. Reverend Dr. Roberts underscored that while the implications for the economy and public health are great, the expansion of Medicaid is simply where our core values lie as a nation. As an example, she summarized the story of the Good Samaritan, in which a man takes care of a neighbor in need at his own expense.
“It’s not a merit-based medical system,” she said. “It’s not a positional-based medical system. It’s based on the common good and on who we consider ourselves as neighbors, and as Jesus says, it’s the one that shows mercy. That is the moral imperative and the justice issue.”
She also highlighted instances in scripture where those in positions of power, such as formal religious or governmental positions, feared the loss of that power. “Folks are afraid to share the power of what it means to be working for the common good,” she said.” The solution, she said, is in understanding that we have a God of abundance, rather than scarcity. Throughout all of scripture, as she pointed out, it’s impossible to find a place where the power of God or Jesus turns down caring for a widow, an orphan, or a person living in poverty. Instead, each example depicts Jesus extending a hand to the most vulnerable.
Circling back to Dr. Simari’s comments on the social determinants of health, Reverend Dr. Roberts pointed out the other barriers to care intersecting with the lack of accessible insurance. She highlighted the food deserts in communities of poverty in and around the Kansas City area especially as an example, describing accessibility to a healthy lifestyle as a justice issue.
“A God of generosity and hospitality asks all of us to look at those who are the weakest in our community and ask ourselves, ‘How do we in fact find a way to offer access to healthy lifestyles?’” she said. “There are medical care deserts where we make it hard for people to invest in a healthy lifestyle if they want to. We don’t make that accessible, and accessibility is a justice issue, and so the concern becomes how we can work with each other, together, across the boundaries of politics and business, and faith traditions, to work together for the common good for all of us.”
Reverend Dr. Roberts added that historically, the United Methodist Churches have been involved in health care and improving access for those in poverty, dating back to the 18th century. “We believe it’s a basic human right. It’s been voted on, it’s in our book of governance, that it is a basic human right for everyone to have access to adequate health care.”
Pile on the Pressure
Regardless of reason, all speakers agreed that it’s imperative to keep the pressure on in the fight for Kansas Medicaid expansion. “I know we’re preaching to the choir, I get that,” Reverend Dr. Roberts said. “But you, who are in the choir – how many people do you have in your spheres of influence? You have multiple people, whether that’s your dog groomer or professional colleagues. If you talk about it, and you let them know what your values are and why, then it begins to spread.”
Along with keeping the conversation going, Dr. Simari stressed the importance of education, especially for those in the medical profession. In the past, the outcome of patient health was solely determined by the health care they received. However, the last decade brought to light the role that social determinants of health play and the impending effects on access to quality care.
The Bottom Line
There is no strong evidence in any state that has expanded Medicaid that it has cost or harmed their economy or had any sort of negative impact. Some states have had expanded Medicaid coverage since 2014; since, none have decided to overturn or repeal the decision.
“We need to continue this dialogue and not let up,” Reardon said. “We’re proud of the fact that Missouri has moved in the right direction, and I think that’s further evidence that all of us in Kansas need to take that move.”
There are three ways individuals can remain involved in the fight to expand Medicaid in Kansas:
- Stay engaged in the dialogue and work by sharing personal testimonials and connecting with local organizations.
- Ensure you, your employees, friends, and neighbors are registered to vote and stay up to date on issues that matter. Find out where those who represent you stand on these issues.
- Share resources with others to continue facilitating education.
Watch the recording of “Business, Faith, Health: Why Medicaid Expansion is Right for Kansas” on YouTube.
- Umbrella organization for resources and opportunities regarding KanCare Expansion in Kansas: Alliance for Healthy Kansas
- Upcoming opportunities for engagement: Kansas City Medical Society Foundation
- Assistance for healthcare partners to get your colleagues and patients registered to vote: https://vot-er.org/
Check out your local Chamber as many have included Medicaid Expansion in their legislative platforms.
- Greater Kansas City Chamber of Commerce
- Kansas City Kansas Chamber of Commerce
- Overland Park Chamber of Commerce