The following op-ed ran in the Topeka Capital Journal on October 30.
It’s been a few weeks since the announcement that Mercy Hospital in Fort Scott will close by the end of the year. The residents of Fort Scott and surrounding communities are now confronted with the same grim realities faced by other communities, including Independence three years ago, when the local hospital closes — diminished access to health care services, loss of jobs and economic opportunity, a strain on other community services, and the reality that a fundamental pillar of the community is gone.
These issues are not unique to Fort Scott. According to the Sheps Center for Health Services Research at the University of North Carolina, which tracks and analyzes these issues, 58 rural hospitals have closed since 2014. In Kansas, an analysis by iVantage Health Analytics estimated that one-third of Kansas’ rural hospitals, more than 30 facilities, are at risk of closure.
Sadly, these closings are in many ways a self-inflicted wound. With the expansion of Medicaid, many states have been able to save their hospitals while insuring hard-working residents who need coverage. Unfortunately, Kansas is not one of those states.
Rural communities are especially susceptible to the negative effects that come when a state does not expand Medicaid. Because of the nature of their work and where they live, residents of rural communities have lower incomes and are more likely to suffer from chronic illnesses than residents of urban and suburban areas. At the same time, rural communities have higher rates of uninsurance. As such, rural hospitals are at far greater risk of closure than urban hospitals.
Historically, Kansas has been an early adopter and enthusiastic supporter of programs that support rural health and rural hospitals.
When Critical Access Hospitals (CAH), for example, were created some 20 years ago, Kansas was ready. The state had already participated in a pilot program to test the concept. State officials committed resources, developed partnerships, and made necessary changes in state policy to embrace the program.
Times have changed, however, and Kansas no longer leads when it comes to rural health. Despite support from a broad coalition of stakeholders, including hospitals, doctors, social services providers, farmers, businesses, faith communities, and ordinary Kansans, the state has yet to adopt what may be the most significant rural health policy measure since the CAH program – expanding KanCare, the state’s Medicaid program.
Thirty-four other states, many with large rural populations like Kansas, have reaped the benefits of Medicaid expansion. In Kansas, expansion would provide health coverage to an estimated 150,000 Kansans, many who live and work in rural communities. Getting health coverage will not only help these Kansans receive the care they need, it will reduce their medical debt and enhance the financial security of their families.
KanCare expansion will also bring significant new revenue to local hospitals, enhancing the financial stability of these critical community institutions. And it’s not just about covering the uninsured – when a local hospital closes, everyone loses ready access to health care.
It’s time for Kansas to embrace its heritage as a leader in rural health and expand KanCare.
2018 Special Order of Business: Medicaid Expansion
We urge the Kansas Legislature to expand Medicaid and rural healthcare services. Continued lack of action leads to the decline and depopulation of our great state. One rural hospital recently closed, and others are struggling. Any further delay in implementing Medicaid expansion in Kansas only contributes to the accelerated economic decay of the rural healthcare infrastructure of the state.
