Commentary by Kyle Hoffman, 116th District state representative — Living in a small community and helping with the health needs of aging parents, I know that access to healthcare is important to rural communities like Wellington and the surrounding area. With that in mind, I appreciate the opportunity to respond to Tracy’s Sunday Blog and Mr. Deschaine’s coments about Medicaid. It’s necessary to share a few important factors about Medicaid expansion that the people of Wellington deserve to know.

Kyle Hoffman

First a little background, Medicaid is the government healthcare program for low-income and disabled Kansans. It’s designed to serve truly vulnerable people—Kansans who are physically or intellectually disabled, children, pregnant women, women who’ve given birth in the last year, and the frail and elderly. Medicaid expansion would begin including able bodied adults without children who have income up to 138 percent of the federal poverty level, some who already have private health insurance now.

The federal government under Obamacare entices states to expand their Medicaid programs with the promise of “free money,” but history shows that the feds rarely keep their funding promises. Although as McCue and Deschaine said, there is no proof that the money will disappear, the money is also not guaranteed. Earlier this month, the U.S. Congress voted to dismantle Obamacare–including the money for Medicaid expansion. The vote indicates there is a very real possibility the federal law will be repealed and replaced once President Obama leaves office. Making our local hospital reliant on a law that has a high likelihood of being repealed is unwise.

Even if Kansas was to expand Medicaid and the ACA were not repealed, the price tag for our state will go up. By the year 2020, the state would pick up 10 percent of the cost of expansion. Preliminary estimates show the expansion will add up to $1.2 billion of expenses to the state by 2025. That’s approximately one-sixth of our state’s general fund spending. It’s also a huge increase on top of already rising costs in our Medicaid expenses, which today amounts to over $1.1 billion in state dollars alone. Other states that have expanded, such as Colorado, Indiana, New Mexico, Oregon, Ohio and others have seen skyrocketing costs and enrollment jumps way above estimates, in the case of Colorado, enrollment was 207 percent above predictions.

Lawmakers in those states are now dealing with the fallout that has endangered not only Medicaid itself, but other large areas of state spending like education and public safety. There is real evidence that the addition of able-bodied adults without dependents would strain the entire Medicaid safety-net that is designed to serve the truly needy. That is not compassion and that is not good public policy.

Hospitals have pushed hard to expand Medicaid and there’s no doubt that rural hospitals face challenges while serving communities like ours. Sumner Regional Medical Center (SRMC) is no different, but Medicaid Expansion under Obamacare is not the answer to those challenges.

Obamacare has exacerbated those challenges by cutting Medicare–the federal program that covers seniors–by 2 percent. Although I requested information through the Kansas Legislative Research Department from SRMC regarding how much they lost when Medicare was cut, I never received an answer. Regardless, Medicaid expansion would not fill the hole created by cuts to Medicare, not by a long shot. Other hospitals in the area, such as Comanche County, would regain only 20 percent of the money lost under cuts to Medicare. Medicaid expansion is not the answer to money problems created by Obamacare, and it’s certainly not a cure-all for the struggles SRMC faces.

Finally, unlike what you may have heard, there is no pool of free money that Kansas is missing out on by not expanding. According to the Congressional Research Service, the idea that states that do not expand are sending federal tax dollars to the states that do expand is false. Not expanding just means fewer dollars that the U.S. government borrows from China to add to our country’s more than $18 trillion debt.

It’s obvious that rural hospitals face a variety of complex challenges. I am pleased Governor Brownback has initiated a working group to address the problems of health care delivery in rural Kansas. We should find a Kansas solution that will improve rural healthcare access and outcomes for the long-term, not expand the failure that is Obamacare.

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