Don’t buy the myths: Medicaid expansion would make Kansas health care better, cheaper | Opinion

An emergency room in Fort Scott, Kansas, is the latest casualty of the state’s stance on Medicaid expansion. Today, Kansas sits among just 10 states that have failed to leverage federal dollars to increase needed health care access, improve the local economy and give rural hospitals a fighting chance to survive.

2024 marks the decade anniversary of Medicaid expansion, the ability for states to cover adults under the age of 65 with incomes up to 138% of the federal poverty level. Today, approximately 21 million Americans in 40 states and Washington, D.C., have adopted Medicaid expansion.

But not Kansas. Instead, Kansans continue to send our tax dollars to support the health care of our brethren in other states, including neighboring Colorado, Missouri, Nebraska and Oklahoma.

With a decade of data available and 40 states on board, the Kansas Legislature is running out of excuses to paint Medicaid expansion as bad policy. Let’s tackle a few of these myths.

Myth: Medicaid expansion would increase taxes

False. During 2014–17, Medicaid expansion was associated with a 4.4 to 4.7% reduction in state spending on traditional Medicaid. Medicaid expansion allows states to shift certain populations from traditional Medicaid eligibility to the Medicaid expansion category, where the federal government pays a much larger portion of the cost.

More compelling: Of the 40 states that have expanded Medicaid, 25 have cut individual income tax. And in 2023, most of these states ended their fiscal year with a budget surplus.

Myth: Medicaid expansion would enlarge the welfare state

False. Safety net programs aren’t welfare. Medicaid would give Kansans access to health care — not free food, stimulus checks or subsidized housing.

Furthermore, Medicaid doesn’t discourage anyone from working. Federal survey data from 2021 reveals that 6 in 10 non-adults under age 65 with Medicaid work full- or part-time.

Healthy workers are more productive workers. Look no further than Simmons Foods, a pet food manufacturer that built a primary care clinic for its employees in Emporia. If you want a strong workforce, give people access to the care they need.

Myth: Medicaid expansion would increase wait times, reduce access

False. Few studies examine the impact of Medicaid expansion on patient wait times, and one showed a three- to seven-minute delay in seeing a provider within emergency departments. But this is not a product of Medicaid expansion — it is a direct result of supply and demand. We don’t have enough health care professionals in the United States, and haven’t for some time.

The Bureau of Labor Statistics projects a shortage of 195,400 nurses by 2031, and the Association of American Medical Colleges anticipates a shortage of 124,000 physicians in the next 12 years. In Kansas, 90% of counties are what the Health Resources and Services Administration classifies as Health Professional Shortage Areas. And 50% of the counties don’t have a primary care provider at all.

Without significant and intentional changes in provider supply, most Kansans will be waiting longer to see a doctor — no matter which insurance card they carry.

Myth: Medicaid expansion is useless for rural hospitals

False. According to the 501(c)(3) nonprofit KFF (formerly the Kaiser Family Foundation), health systems in expansion states experienced stronger financial performance for rural hospitals. Notably, all studies that considered emergency department rooms found improvement in the departments’ financial performance.

I can’t help but think about the 7,550 residents in Fort Scott, now the ninth Kansas town without an emergency room.

The will of the people

Polls show 70% of Kansans support Medicaid expansion. More than 130 of the state’s employers have endorsed expansion, and locally, so do the Johnson County Commission and the Unified Government of Wyandotte County and Kansas City, Kansas.

The people of Kansas have never needed a handout and have always valued independence and individual rights. That’s not just in the state’s origin story opposing slaveholders, but also in 2022 when 59% of Kansans voted to protect a woman’s autonomy and ability to make her own decisions related to reproductive rights—the first state in the country to do so. Kansans also have always expected a government that works for them.

It’s time to work for the 150,000 Kansans who would breathe a little easier with access to health care. Drop the excuses, and support Medicaid expansion as a policy for the good of all Kansans.

Jeron Ravin is president and CEO of Swope Health, which operates three clinics in Wyandotte and Leavenworth counties.