Brenda Sharpe, of Overland Park, is the president and CEO of the REACH Healthcare Foundation in Merriam, Kan., a charitable organization that supports health services for low-income and uninsured people. The foundation invests nearly $5 million a year in local and regional health programs.
For those ready to talk about what the health care law really means to the states, the Patient Protection and Affordable Care Act, which the U.S. Supreme Court largely upheld in its ruling in June, represents an opportunity for almost 500,000 people in Kansas and Missouri to have access to the health care coverage most of us take for granted.
Our states now face a decision that could bring that health care access closer to home or continue to keep hundreds of thousands of people on the margins.
The Supreme Court ruling allows each state to decide whether to opt in to expansion of the Medicaid program for low-income citizens. As currently structured, Medicaid can hardly be called an entitlement. It provides health care coverage for poor children, pregnant women, the elderly and people with disabilities.
The new Medicaid expansion is not for people who can afford health insurance but simply choose not to purchase it. Instead, the intended beneficiaries are those who earn less than $14,856 a year. Citizens who earn barely enough to maintain housing and put food on the table might now be able to have health coverage.
In Kansas, 141,000 adults would be newly eligible for coverage through Medicaid starting in 2014; in Missouri the projection is 351,000 adults.
For our financially strained state governments, it’s important to note that the federal government will pay the costs for newly eligible Medicaid recipients for the first three years. The states will assume 5 percent of the cost starting in 2017, increasing to 10 percent in 2020. For our two states to consider opting out of Medicaid expansion, thereby turning down the additional federal support, ignores an opportunity to help our residents and our state outlook at very little cost.
Consider the economic impact: Most hospitals across our states receive supplemental payments to provide health care for the uninsured. These payments will be phased out starting in 2014 because of efforts to expand health care coverage.
Kansas hospitals received more than $41 million last year to cover uncompensated care; Missouri hospitals received $474 million.
If Kansas and Missouri refuse to take advantage of this new avenue for health care coverage, our hospitals will face a tremendous funding shortage. In largely rural states like ours, where most counties have a single community hospital and high levels of poverty, the phase-out of payments to cover uncompensated care could result in cuts in medical care, jobs and even the potential closing of some hospitals, the biggest employer in many rural communities.
Urban hospitals also will suffer because of the volume of uninsured people they serve.
Finally, Medicaid expansion will reduce state spending on chronically underfunded but critically needed mental health services for uninsured adults. States currently cover about 40 percent of the funding for mental health services, and still, resources and services can’t meet demand.
I understand that state leaders who have opposed the health care act may find themselves in a challenging situation politically in deciding whether to move forward with Medicaid expansion. However, Kansas and Missouri leaders have a history of doing what is right for people in the end.
Our elected leaders say the economy is the most critical issue. A healthy and productive citizenry is one starting point — and protecting the health care jobs that are the backbone of our communities is another.
Let’s take this opportunity to put our federal tax dollars to work in our own states, and move beyond our differences so that we can improve the health of our people and states today.