State senate candidates on the issues: Should Medicaid be expanded in Kansas?

Dan Blom - October 12, 2016 11:00 am

We sent questions last week to candidates for state senate in Districts 6, 7 and 10, all of which cover at least a portion of northeast Johnson County. The questions we selected came from a large number submitted by readers.

By the deadline for the third question, we had received the following responses. They appear below. Today’s question is:

Are you in favor of expanding Medicaid in Kansas and accepting the federal funding? Please explain your philosophy

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Senate District 7

Megan England

Megan England
Megan England

This issue hits home for me. Kansans with disabilities face an 8 year waiting list for services. Rather than fix the problem, state Republicans put “Party before People” to protest Obamacare. But it’s Kansans who are paying the price- literally. In the last two years, over 1.4 billion of our federal dollars meant for Medicaid expansion have been lost because this administration would rather send a message to Obama than help those they swore to represent. Instead, they replaced it with KanCare – a private, predatory, for-profit “experiment”. We taxpayers pay for that too. KanCare extorts our most vulnerable, destroys small business, proliferates poverty, and has pushed hospitals to close. There is no oversight, no transparency, and no accountability to the public. In fact, the Managed Care Organizations (MCOs) financially benefit each time a service for an individual is reduced. KanCare’s profits in four years have reached into the hundreds of millions.

Like many District 7 residents, I was told Dr. Bollier was my answer. As a senior legislator and only M.D. in the State House, we were counting on her to be our bold voice. Since the roll out of KanCare four years ago, she has never introduced or supported legislation to change it. Last week she stood in front of 100+ disabled KanCare recipients, care providers and family members (including myself), boasting about her degree and legislative experience. Not once did she address the core of the problem (the predatory, for-profit MCOs). Instead, she joined other Republican law-makers in making sheepish excuses for themselves and their party, playing the “victim of Brownback” card as she told the audience not to expect change any time soon. It left me angry, upset and resolved. My loved ones deserve so much more.

How can we fix it? Just like every other failed “experiment” our leadership has enacted since 2010, we overturn KanCare and go back to the State run system that ran so smoothly before it was dismantled. Yes, we need to expand Medicaid; but we cannot allow it to be held hostage by for-profit providers.

Spend time with someone fighting for fair treatment with KanCare. Google the name Finn Bullers. You will understand our outrage.

Our elderly and disabled are not line items or boxes to be checked. They deserve to be provided the ability to live in dignity despite their challenges.

No more excuses. It’s time for change.

Barbara Bollier

Barbara Bollier
Barbara Bollier

Every day in the Capitol when we say the Pledge of Allegiance, I follow “…with liberty and justice for all” with “and expand Medicaid”. Social justice is imperative in a stable society. I was proud to be part of the Vision 20/20 committee that passed a Medicaid expansion bill. Unfortunately, the House Speaker would not allow the bill to move forward for even discussion, and blocked any possible legislation that might provide opportunity for an amendment to expand Medicaid. Democrats and Republicans alike were stymied by our past leadership. But the Kansas Primary has brought forth a new potential for this critical issue. We at least will be able to move a bill out of committee and on for discussion in both the House and Senate.

In the midst of campaigning, I have been serving on a select committee of House and Senate leaders to move Medicaid expansion and reform of the KanCare sytem forward in Kansas. From both an economic standpoint (we have missed $1 billion coming into our state economy) and from a justice standpoint I firmly support Medicaid expansion. I look forward to having a new set of colleagues that are willing to put this issue on the table as the people of Kansas have asked.

Senate District 10

Mary Pilcher-Cook

Mary Pilcher-Cook
Mary Pilcher-Cook

Expanding Obamacare Medicaid in Kansas would increase health care costs to Kansas citizens, with Medicaid enrollees obtaining only 20 to 40 cents for every dollar spent by taxpayers (Brian Blase research report, May, 2011 https://www.heritage.org/Research/Reports/2011/05/ Medicaid-Provides-Poor-Quality-Care-What-the-Research-Shows ). When providers (your own doctor) are paid a lower amount for Medicaid patients, they make it up by charging more to those who are not on Medicaid. In addition, the federal money is unreliable and would soon be decreased dramatically, leaving the state on the hook.

My priority is ensuring that our state can continue to take care of our most vulnerable citizens who are most in need of Medicaid coverage. In Kansas, children, pregnant mothers, many poor elderly adults who need care in a nursing home, individuals with disabilities and mental illness are covered by Medicaid. So Obamacare Medicaid expansion would only be for able-bodied adults. It would not help in taking care of individuals with disabilities, or provide care to additional elderly citizens.

Other states have seen the number of patients expand far beyond their ability to pay after the federal subsidies expire, and once states opt into Obamacare Medicaid expansion, they relinquish control to federal bureaucrats. States can’t change anything without permission from Washington DC, often to the detriment of patients.

As far as hospitals are concerned, a recent report by the Congressional Budget Office has concluded, “Medicaid expansion will not make a material difference in hospitals’ overall viability.” We have had rural hospitals fail in Kansas, but not because Kansas didn’t expand Obamacare Medicaid.

In a recent report to Congress, the Centers for Medicare and Medicaid Services said the cost of expansion was $6,366 per person for 2015, about 49 percent higher than previously estimated. Fiscal sustainability is key and the expansion of Medicaid in other states has proven to be a fiscal disaster.

For example, in Ohio, the Medicaid program went $1.5 billion over budget in the first 18 months. In Illinois, $800 million. In Kentucky, $1.8 billion. Washington State increased its biennial budget by $2.3 billion just to deal with expansion costs.

To help the unfortunate, I was able to get legislation passed that would provide quality charitable health care in Kansas. By reducing government regulations and protecting providers from lawsuits, this new law allows physicians and dentists the ability to volunteer and provide the best health care possible to patients in poverty without all the government control.

Vicki Hiatt

Vicki Hiatt
Vicki Hiatt

Have you ever sent money to the federal government and then, when offered a chance to get it back said no? That’s what the state of Kansas does on your behalf with every paycheck.

There are multiple paths to Medicaid expansion. My opponent, Mary Pilcher-Cook, has been one of the strongest opponents of Medicaid expansion. Her work in the state house has been to block and delay all measures in regards to Medicaid expansion, to the extent that she had her chairmanship revoked.

Mike Pence, current Republican Vice Presidential Nominee, accepted Medicaid expansion in Indiana. Other Republican governors and 26 states have also accepted expansion. Why did Mike Pence do so? It has to do with understanding the way in which the US Medical system works.

Under the law, hospitals must accept patients with need, regardless of their insurance or ability to pay. Patients may be transported to them lacking the ability to tell staff this vital information but still need treatment. Hospitals, as a result, may end up stuck with bills from patients that they will never be able to cover.

As preventative care, Medicaid expansion helps make sure more patients do not need expensive hospital stays. A healthy Kansas family means children miss fewer days of school, parents miss fewer days of work, and our business community benefits.

I’m proud to be endorsed by the Kansas Hospital Association, who understands the situation in Kansas. By their math, the state has rejected more than $1 Billion in federal resources.

Who gets hit the hardest? Often, it is religious hospitals. While community hospitals can raise public funds, private Catholic hospitals in Kansas have been among the hardest hit. In Independence, Kansas, Mercy Hospital was forced into closure. St. Francis hospital in Topeka is now up for sale. (https://cjonline.com/news/business/2016-05-26/st-francis-health-owners-seek-new-operators-topeka-hospital)

Sen. Pilcher Cook has referred to Medicaid Expansion as “evil”, and a way to attack those with disabilities. In fact, Mike Pence in accepting Medicaid expansion for his home state noted that it helped significantly improve the lives of the disabled. (https://www.in.gov/fssa/4913.htm )

Because both presidential candidates have supported Medicaid expansion (https://www.bloomberg.com/politics/articles/2016-09-15/trump-calls-for-expanded-medicaid-birth-control-without-doctor) it is not going to go away anytime soon, no matter who wins the presidential election.

As a result, I would urge us to accept Medicaid expansion and work with our hospitals to improve health care. My opponent can feel free to fight with both the Republican and Democratic nominee for president, or we can accept Medicaid expansion and give Kansas hospitals a chance to survive.

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