The announcement that Mercy Hospital in Independence will close its doors on Oct. 10 has caused at least one powerful Kansas legislator to indicate he might be willing to look again at the state’s options for expanding Medicaid.

The hospital closing literally hit home for Senate Vice President Jeff King, who lives in and represents Independence, in southeast Kansas. After hearing the news, King said he’d “never been amenable to just an expansion of the Affordable Care Act, also known as Obamacare. But as we look at states like Indiana that take a real state-centric approach to addressing the health care needs of their poor, I think that’s something that Kansas needs to strongly consider.”

What such a system would look like for Kansas is unclear, but hospitals and other health care providers in the state must be pleased to see some willingness to revisit the state’s decision to turn down all expanded Medicaid funding.

Hospitals, especially those in small communities, have suffered because of that choice. Part of the funding strategy for the ACA was to reduce Medicare reimbursement rates on the assumption that increased funds from Medicaid expansion would offset those losses. In Kansas, hospitals have seen their Medicare revenues drop without any corresponding Medicaid rise.

Tom Bell, president and CEO of the Kansas Hospital Association said that expanding Medicaid, as called for under the ACA, would have meant an additional $1.5 million a year to Mercy Hospital. That might not have been enough to save the hospital, he said, but it “would have been a significant part of their discussions.”

Bell also said that the Mercy Hospital closing may be the first of several in the state, and the federal reimbursements are no small part of the picture. The hospital association estimates that lower federal reimbursement rates are costing Kansas hospitals $132 million a year and that those hospitals are providing nearly $1.2 billion a year in uncompensated care. If Kansas expands Medicaid, the group estimates a net gain of $231 million a year in federal reimbursements and a 33 percent reduction in uncompensated care.

Opposition to Medicaid expansion has been strong in the Kansas Legislature, but the leadership of Sen. King could provide an opening for new discussions. As King said, a Kansas plan would have to be a “state-centric” plan, but 30 other states and the District of Columbia all have found acceptable ways to implement some kind of Medicaid expansion.

The refusal to consider various options to expand federal reimbursements is taking a toll on Kansas hospitals, as well as individual patients. The loss of a hospital is devastating to a small community. Perhaps the closing of Mercy Hospital in Independence will provide a needed wake-up call on this issue.