Opinion: Gun deaths and Medicaid expansion

Medicaid expansion has been a hot topic over the past decade. Despite many states across the country expanding their Medicaid programs under the Affordable Care Act, Kansas has yet to do so.

According to the 2022 Kansas Speaks public opinion survey distributed by the Docking Institute of Public Affairs at Fort Hays State University, nearly 76% of Kansans support KanCare expansion. KanCare is the name of the state’s Medicaid program.

Despite extremely high levels of public support, the state Legislature has failed to expand KanCare. The reason is most often attributed to partisan politics.

However, opponents of KanCare expansion may want to take a second look at some specific benefits of extending the program, 90% of which would be paid for by the federal government.

The RAND Corporation, a nonpartisan policy think tank, has published new data about state-level firearm related deaths.

According to their findings, Kansas’ firearm death rates are 24% higher than the national average. This high percentage is driven mostly by the state’s firearm death by suicide rate, which is 46% higher than the national average.

Firearm homicides are 7% lower in Kansas than the national average.

Contrary to popular belief, gun violence is not unique to urban areas.

New research published in the Journal of the American Medical Association last month finds that gun violence is not even predominantly an urban issue — an argument that is generally used as justification for loosening gun laws. Rather, all areas of Kansas are impacted by gun violence. Especially self-harm via firearms.

In Kansas’ rural areas, firearm deaths are 14% higher than the national average, firearm deaths by suicide are 25% higher, and rural firearm homicides are 9% lower.

What does this have to do with KanCare expansion?

Research from the Kaiser Foundation finds that Medicaid expansion increases access to care for adults with mental health conditions such as depression.

Medicaid expansion is associated with an increase in the number of mental health facilities accepting Medicaid patients and an increase in the number of visits individual patients make to mental health providers.

Medicaid expansion is especially beneficial in providing much needed mental health care to rural residents, as nearly half of all mental health professional shortage areas nationally are located in rural areas.

Furthermore, a report from the Kansas Health Institute and the Alliance for a Healthy Kansas found that an estimated 24,154 Kansans are likely to use extended mental and behavioral health services under KanCare expansion.

Another research study published in JAMA, this one in June 2022, finds that an average of 1,818 deaths by suicide were averted in Medicaid expansion states after the expansions — mostly among 20- to 29-year-olds.

Expanding KanCare could — and, based on the research, likely would — prevent firearms deaths, especially those by suicide, in our state.

— Alexandra Middlewood is an assistant professor of political science at Wichita State University.

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