February 2023 President’s Message

February 2023 President’s Message

Kansas and its citizens suffer without Medicaid expansion

by Maurice Duggins, MD —

It is clear that electric vehicles (EVs) would not have made the progress they have without the funding support of the government. If you don’t believe me, ask Ford, General Motors, Nissan and Tesla. These companies were beyond believing that EVs were good for the environment. For them, the cost associated with building the right type of vehicle with the right travel range at the right, affordable price was a nonstarter.

The government knew that this was an obstacle, so it subsidized the price of EVs. The states also pitched in by offering physical space and tax incentives to help companies create factories to build cars and batteries. Why were these incentives needed? Because to make an EV was one thing, but to make it affordable for regular folks was another thing.

Consider the amount of money individuals needed to purchase a Tesla in 2012 compared with today. It used to be only the rich could afford a Tesla. Now, with tax credits, a Tesla is affordable to many more people. All that is to say, when the government has placed financial resources behind things that are good, it has made our nation, states and counties better.

One struggle the federal government has is finding ways to encourage states to expand Medicaid services. Currently, 39 states and the District of Columbia have expanded Medicaid.

Unfortunately, Kansas is among the 11 states without Medicaid expansion. We stand out in the middle of the states surrounding us that have expanded Medicaid benefits to their citizens. The ability to expand this service has been available since about 2010, but having the Legislature and our governor landing on the same page at the same time to expand Medicaid has been unsuccessful.

It is Kansas and citizens that suffer without Medicaid expansion. It is estimated that over 150,000 Kansas citizens could benefit from Medicaid expansion. That’s a lot of souls who are not receiving the full access to health care they deserve. The federal government has provided generous subsidies to support this program, thus allowing citizens to benefit from the expansion. Many of these citizens are the ones we see in the emergency rooms because they don’t have the insurance needed to see a primary care physician in a timely enough manner to avoid the use of the emergency room.

Hospitals also suffer without Medicaid expansion. They absorb the cost of taking care of many uninsured or underinsured patients. They cannot recoup enough revenues from such patients. This amounts to a loss in revenue estimated in billions of dollars. Expanding Medicaid would assist with the cost of taking care of these patients. It could also help keep rural hospitals from closing.

In addition to expanding Medicaid, the state needs to adjust Medicaid reimbursement rates, which haven’t increased in 17 years. Because of low reimbursements, some physicians don’t accept Medicaid patients or they limit the number of Medicaid patients they see. That puts more burden on the physicians left to take care of the patients who need ongoing prevention and care.

It is Black History Month, and I am reminded of a quote from Martin Luther King, Jr: “History is the long and tragic story of the fact that privileged groups seldom give up their privileges voluntarily.” The state has a budget surplus in place to afford Medicaid expansion. We have a governor who will sign off on Medicaid expansion. Polls show the public overwhelmingly supports it. Now we need to ask the legislators to offer the same privileges that they enjoy to their eligible constituents by expanding Medicaid.