For more than 50 years, Medicaid has been our nation’s health care safety net — paying health care costs for people with very low incomes, people with disabilities, and some older adults. When the Affordable Care Act passed in 2010, it included a provision to expand Medicaid eligibility. A 2012 Supreme Court decision made this coverage expansion optional. Twelve states, including Kansas, opted not to expand — a move that has left many small-town hospitals and rural communities on life support. Now, Congress is considering additional incentives to make expansion more appealing to states, so that more people can get coverage and more community hospitals can continue to operate.

In this film, the Commonwealth Fund invites Tim Hay, Fire & EMS Chief, Wellington, Kansas; Kathleen Sebelius, former U.S. Secretary of Health and Human Services (2009–2014) and former Governor of Kansas (2003–2009); and April Holman, Executive Director, Alliance for Healthy Kansas, to discuss the value of Medicaid, the rapid decline and closures of hospitals in rural communities, and what Medicaid expansion in non-expansion states might mean for achieving universal coverage.