By PHYLLIS ZORN

Staff writer

Expanding of Medicaid as 40 other states have done is a priority for Kansas Governor Laura Kelly but could create a complicated situation for Marion County hospitals.

“We don’t turn patients away, whether they have insurance or not,” St. Luke Hospital chief executive Alex Haines said

Medicaid expansion would reduce the hospital’s number of uninsured patients, but increased payments to the hospital would not make a lot of difference, he said.

“$101,000 a year is what Medicaid expansion would mean to St. Luke,” Haines said. “Medicaid payment doesn’t cover the cost to us.”

The governor has pressed for Medicaid expansion every year she has been in office, but the legislature has not agreed. Haines said he would like to see the issue resolved one way or the other so people could turn their attention elsewhere.

“From a community standpoint, there are people that aren’t getting care because they don’t have insurance,” Haines said. “It’s a highly contested idea with the state. I really encourage people to reach out to their legislators.”

Hillsboro Community Hospital chief executive Mark Rooker favors Medicaid expansion.

“Any additional dollars would be beneficial in covering the expense of care provided,” Rooker said. “Medicaid expansion would not solve every problem Kansas health care providers face, but it would be a step forward for preserving essential care in our rural communities.”

According to Kansas Action for Children, most low-income children are eligible for KanCare Medicaid and CHIP programs, but about 38,500 of those children are not signed up.

“Expanding KanCare is critical to reversing this concerning trend,” Kansas Action for Children states in a news release. “Studies show that when parents sign up for insurance programs, they are more likely to enroll their kids as well. And kids’ health reflects the health and well-being of their parents. When parents are insured, kids are more likely to receive regular checkups and preventive care.”

Parents rarely qualify for KanCare because qualifying income limits are extremely low.

Parents or caregivers of children qualify for KanCare if their income is 38% below the federal poverty level. If a family of three makes more than $9,444 a year, they do not qualify. A single mother working a full-time minimum wage job earns about $15,000 a year.

Without a employer-sponsored health insurance plan that the family can afford, such people can fall into coverage gaps. A family of three must make more than $24,860 a year to qualify for subsidies to purchase insurance through the government’s health insurance marketplace.

An estimated 109,000 adults and 39,000 children could sign up through KanCare, the state-run Medicaid program.

A Kansas Hospital Association statement provided by Rooker pointed to advantages of expanding Medicaid.

“There are many reasons it’s harmful for so many Kansans to be uninsured, including those dedicated to providing health care in communities across our state,” the statement said. “Uninsured Kansans are less likely to get access to the care they need, and if they end up in the emergency room, the hospital often must cover the bill — what we call ‘uncompensated care.’

“To address this, the federal government now offers states funding to expand Medicaid to people in that coverage gap. The federal government covers 90% of the costs, the states cover 10%.

“Because Kansas hasn’t taken advantage of this opportunity, our federal tax dollars are going to support hospitals and health care providers in other states instead of right here at home. Estimates suggest expansion would create roughly 23,000 jobs in Kansas, spur $591.7 million in new annual health care spending in Kan-

as, and decrease uncompensated care costs.”

Haines said he thought regulatory relief would help hospitals more.

Many insurance plans require prior authorization for a patient to be admitted. If a patient comes to an emergency department and needs care, the insurance company can take as long as three days to authorize admission. The state insurance commissioner is looking at authorization regulations, he said.