Kansas Health Institute: In Kansas’ richest county, Medicaid expansion’s absence still felt

Kansas Health Institute: Health officials say Johnson County losing revenue, benefits due to coverage gap.

Tim DeWeese highlighted Johnson County’s neediest residents Monday while briefing an audience about what the county is losing because Kansas policymakers have declined to expand Medicaid under the Affordable Care Act.

DeWeese, executive director of the county’s mental health agency, said there are people living under bridges or “surfing” from couch to couch in the state’s most prosperous county — and they didn’t come in from elsewhere.

“There is a homeless population, here in Johnson County,” he said.

DeWeese spoke at the Jewish Community Center in Overland Park as part of an event hosted by the Alliance for a Healthy Kansas. It was the seventh stop at venues across the state as the alliance seeks to build grassroots support for Medicaid expansion in an election year.

The alliance is funded in part by the Kansas Health Foundation, which is the primary funder of the Kansas Health Institute, the parent organization of the editorially independent KHI News Service.

The alliance estimates that Medicaid expansion would extend health coverage to about 150,000 low-income Kansans. Right now Kansas Medicaid, or KanCare, is open only to children, parents, pregnant women, the frail elderly and people with disabilities — and it has some of the nation’s most restrictive income limits for those populations.

The alliance estimates that almost 40,000 Johnson County residents are uninsured and more than 25 percent of them would gain coverage through Medicaid expansion. Expanding eligibility for Medicaid also would bring about $44 million a year into the county’s health care economy, creating an estimated 282 jobs.

Lougene Marsh, director of the Johnson County Health Department, said that though her county is relatively wealthy, in terms of raw numbers it has more uninsured Kansans than almost any other county in the state.

“And we know there are consequences from that,” Marsh said in an interview before Monday’s event. “In our recent community health survey, one out of every 10 people that we spoke with, they said they had problems getting health care. Most of that … was due to no insurance.”

Marsh said Johnson County’s poverty rate is growing, which could leave the county with more uninsured residents in the future.

People who lack health insurance frequently delay medical care until they have a medical crisis, she said, which leads to greater treatment costs.

Anne VanGarsse, chief medical officer of Health Partnership Clinic of Johnson County, said that also can lead to heartache for patients and their families.

VanGarsse said her safety net clinic, which provides primary care to people without insurance, recently treated a female patient who had put off annual tests and screenings because of the cost.

When the woman came to Health Partnership Clinic, she was diagnosed with cervical cancer. VanGarsse’s team then had to scramble to find a hospital that would treat her for free until the illness disabled her enough to make her Medicaid-eligible.

The cost burden for providing care to the uninsured in places like the county health department, the Health Partnership Clinic and DeWeese’s agency falls on local residents.

DeWeese said his mental health agency provided $6 million worth of charity care in 2015, although about $3.5 million of that would have been covered if the state had expanded Medicaid.

“Who did that $6 million come from?” DeWeese asked. “It came from Johnson County taxpayers.”

Kansas is one of 19 states that have declined to expand Medicaid eligibility since a 2012 U.S. Supreme Court decision upheld most of the federal health care law known as “Obamacare” but said expansion was optional for states.

Under the law, the federal government pays 100 percent of the cost of expansion for the first three years. Starting next year states will gradually begin contributing some money, maxing out at 10 percent of the cost starting in 2020.

The Kansas Hospital Association has floated a “budget-neutral” plan that would pay the state’s share in part through an extra tax on health care providers who would benefit from expansion.

Rep. Linda Gallagher, a Republican from Lenexa who was in the audience Monday, said some of her legislative colleagues fear the federal government will renege on its duty to fund expansion.

Sheldon Weisgrau, a health reform expert who is working with the alliance, said that’s no justification for Kansas to turn back its share of the federal funding, which is close to topping $1.3 billion so far.

“The Medicaid program has been in existence for 50 years,” Weisgrau said. “The federal government has not missed a payment yet.”

Read more at: http://www.khi.org/news/article/in-kansas-richest-county-medicaid-expansions-absence-still-felt