Archive for Thursday, April 20, 2017

Editorial: Another go at expansion

Lawmakers owe it to Kansas hospitals to renew their efforts to expand Medicaid.

April 20, 2017


With Topeka’s St. Francis Health Center on life support, it is appropriate for the Legislature to once again pursue Medicaid expansion in Kansas.

David Jordan, who heads the Alliance for a Healthy Kansas, said his group would make another push for expansion when the Legislature returns May 1. The potential closure of St. Francis is an appropriate catalyst for the renewed action.

Denver-based SCL Health, the owners of St. Francis, postponed an announcement about the 378-bed facility’s future for at least two weeks while they continue negotiating with potential buyers. The hospital has been for sale for a year. If no buyer is found, SCL Health said it would not continue to operate the hospital beyond this summer.

If St. Francis closes, it would be the second major hospital closure in Kansas in the last two years, following Mercy Hospital in Independence, which closed in October 2015. Mercy Hospital in Fort Scott announced it is reducing operations, including cutting staff and services, in response to a changing health care environment. Officials with all three hospitals have said Kansas’ refusal to expand Medicaid coverage contributed to the hospitals’ financial issues.

The Affordable Care Act offers federal reimbursement to states to extend Medicaid to those younger than 65 whose family income is no more than 133 percent of federal poverty guidelines. The federal government paid for 100 percent of the Medicaid expansion for 2014 through 2016. Federal funding dropped to 97 percent this year and will gradually decrease to 90 percent by 2020.

Kansas is among 19 mostly conservative states that have refused to participate in Medicaid expansion out of opposition to the Affordable Care Act. The problem for hospitals in those states is that the Affordable Care Act also lowered Medicare reimbursements under the theory that the Medicare reductions would be offset by Medicaid expansion, which would reduce the costly practice of treating the uninsured.

Hospitals in Kansas have been receiving the lower Medicare reimbursements without seeing a decline in uninsured patients. The Kansas Hospital Association supports Medicaid expansion, and officials from hospitals around the state have said that expansion will help their hospitals’ bottom lines.

Last month, the Legislature sent a Medicaid expansion bill to Gov. Sam Brownback that would have expanded KanCare, the state’s Medicaid program, to an estimated 152,000 Kansans. But Brownback vetoed the bill, and an effort to override the governor’s veto fell three votes short in the House.

There’s no indication that St. Francis’ pending demise has prompted a change of heart on Medicaid in the governor’s office. But as close as the Legislature was to a veto-proof vote a few weeks ago, the Topeka hospital’s troubles are a compelling reason for legislators to take the matter up again. They owe it to the hospitals in their districts to try.


Sam Crow 1 year, 1 month ago

Independence Mercy could hardly be called a major hospital. A 39 bed hospital in a small town with a population barely over 9,000 is a remnant from health care delivery of last century. With a larger hospital just 20 minutes away, it just wasn’t needed.

The same can be said regarding Fort Scott Mercy. A 49 bed hospital in a small town of less than 8000 isn’t needed. Pittsburg has a larger hospital offering more up to date services just 25 minutes away. The Fort Scott hospital is yet another left over from decades ago.

Should Eudora have a hospital because it is 20 minutes from the closest hospital ? Hardly.

Topeka isn’t large enough for two large fully functioning hospitals just two blocks from one another. The duplication of services and parallel cost structures is just monetarily inefficient.

As people try to save their jobs saying Medicaid is the reason for the closing, they are just refusing to accept the changes in the delivery of health care and updated transportation abilities.

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