October 2023 President’s Message

Expanding Medicaid in Kansas is the right thing to do

by Maurice Duggins, MD —

Doing the right thing is not always the easiest thing to do. But expanding Medicaid in Kansas is the right thing to do for our patients, our community and our state’s economy.

About 247,000 Kansans, or 8.6%, are uninsured, according to the Kansas Health Institute. That puts Kansas above the national average rate of uninsured citizens. By doing the right thing and expanding Medicaid, we could reduce the number of uninsured by more than 50% and allow more Kansans to go to work with a peace of mind.

The old adage warns that “care delayed too long is care denied.” Not expanding Medicaid delays and denies care to thousands of Kansans. I have seen young patients die due to delayed care. For them and others, no insurance meant trying to ignore the signs and symptoms. No insurance meant trying to avoid debt by not going to see a doctor. No insurance meant showing up at the emergency room when hope was about lost.

Many of my fellow MSSC members were the ones telling these patients and their families that it’s too late. We’ve told them that the breast cancer has gone too far. The prostate cancer has metastasized too much. The colon cancer damage is irreversible. We should reach out and speak to state lawmakers, who have the power to expand Medicaid, because it’s the right thing to do.

Expanding Medicaid is not only the right thing to do for our patients, it also is economically sound. The federal government pays the vast majority of the cost of Medicaid expansion. That means expanding Medicaid brings a huge infusion of federal funds (our tax dollars) to Kansas, which provides a major economic boost that far outweighs the state costs.

That’s one reason why 40 states, plus the District of Columbia, adopted Medicaid expansion. This includes all our surrounding states: Colorado, Missouri, Nebraska and Oklahoma.

Expansion also helps hospitals, which must absorb the cost of uncompensated care. Expanding Medicaid would bring an estimated 140,000 to 150,000 Kansans onto the insurance rolls. Those reimbursements would be especially critical to rural hospitals, many of which, like the recently closed hospital in Herington, are struggling to stay open. These hospitals employ administrators, physicians, nurses and supporting staff members. Withholding Medicaid funds is causing unnecessary job losses and displacements.

I work with the family medicine residency program, and we take care of a disproportionate number of Medicaid patients. As a former medical director of an FQHC, I am also fully aware of the burden our safety-net clinics carry taking care of both Medicaid and uninsured patients in our communities. MSSC’s Project Access program also leverages millions of dollars in donated care for uninsured patients.

I have heard some of my colleagues say that Medicaid does not pay enough. That is true, and MSSC and the Kansas Medical Society have been advocating for payment increases. But if more of us would agree to share the load, we could make a big impact on our community.

When we go to the grocery store and we are asked to round up the cost to the next dollar for a good cause, many of us do it, because we know it’s the right thing to do. Medicaid expansion is similar: It allows us to contribute a little so that everyone can thrive.

In 2010, CBS News reported a story about two parachutists that provides an illustrative metaphor for the morality underpinning Medicaid expansion. Shirley Dygert and instructor Dave Hartsock were on a tandem jump when the parachute malfunctioned. Hartsock made a couple maneuvers to take the brunt of the landing and, in so doing, protected Dygert.

“People keep telling me that it was a heroic thing to do,” Hartsock said. “In my opinion it was just the right thing to do. I mean, I was the one who was completely responsible for her safety. What other choices were there?”

Hartsock decided to do the right thing even though it cost him. Kansas should follow his example and pay the comparatively small cost associated with saving thousands of lives by expanding Medicaid. It’s the right thing to do.