The specific impact of cuts to Medicaid reimbursement rates in Kansas is becoming more clear.

As part of his package of spending cuts needed to balance the state budget for the fiscal year that begins July 1, Gov. Sam Brownback ordered a 4 percent reduction in the reimbursement hospitals and other providers receive for treating Kansas residents covered by KanCare, the state’s Medicaid program. The state is expecting those providers to deliver the same services, but at even lower reimbursements than they receive now.

Some rural hospitals were exempted from the cuts, as were some home- and community-based services for people with disabilities. Although doctors and others who provide care in the rural hospitals will see their reimbursement rates cut, the brunt of the cuts will be borne by doctors, dentists, pharmacies and hospitals in the urban areas of the state. Providers in the Wichita and Kansas City areas will see a reduction of about $38 million in their reimbursements. Lawrence Memorial Hospital announced this week that the 4 percent cut in reimbursements would cost the hospital about $272,000 next year, on top of about $462,000 in other Medicaid cuts.

This will have a significant impact on those hospitals. Via Christi Health, the largest hospital group in the state, cited the loss of an estimated $4.3 million in Medicaid reimbursements as a factor in layoffs that will result in a reduction of about 70 staff positions. The group also noted the $14 million it would have received for providing patient care if the state had expanded its Medicaid program. According to the Kansas Hospital Association, about 150,000 Kansans would be eligible for Medicaid under an expanded program.

The reduced reimbursement rates have a direct impact on the amount of uncompensated care provided by doctors and hospitals. Medicaid patients who come to a hospital emergency room still receive the same treatment, but the lower reimbursements means the hospital receives less for providing that care. To make up for that loss, hospitals are forced to cover those costs in other ways, resulting in increased costs for privately insured patients. Declines in Medicaid reimbursements likely will cause some private physicians to quit accepting Medicaid patients, thereby reducing access to care.

This is another dismal example of how Kansas state government is choosing to balance the state budget not by revisiting tax decisions that benefit wealthier Kansans but by cutting services that support some of the state’s most vulnerable residents and the care providers on whom they depend.