A pa­tient and a provider ex­plain why Kansas should ex­pand Med­i­caid

Modern Healthcare - - NEWS - —Har­ris Meyer

In ve­to­ing a bill to ex­pand Med­i­caid cov­er­age to an es­ti­mated 150,000 low-in­come adults, Kansas Gov. Sam Brown­back said that Med­i­caid should in­clude a strict re­quire­ment that all able-bod­ied adults find a job. “We can­not help our cit­i­zens build bet­ter lives with­out also in­cen­tiviz­ing them to find a per­ma­nent path out of poverty,” he wrote.

But Krista Postai, CEO of the Com­mu­nity Health Cen­ter of South­east Kansas, said that’s the wrong way to look at the is­sue. Her clinic treats many work­ing peo­ple who don’t seek pre­ven­tive care be­cause they lack in­sur­ance and can’t af­ford to pay for health­care.

“We have peo­ple work­ing three jobs with no cov­er­age,” she said. “If you want to main­tain a healthy work­force, they need to have pre­ven­tive care.”

Laura Ash­baugh gets paid $200 a week wait­ing ta­bles at a diner in Chero­kee, Kan., in the im­pov­er­ished south­east cor­ner of the state. In late 2015, she was di­ag­nosed with a large kid­ney stone that re­quired sur­gi­cal re­moval. But she has no health in­sur­ance.

So Ash­baugh worked through the in­tense pain un­til Oc­to­ber, when she fi­nally was able to get an operation through a char­ity-care pro­gram. Af­ter eight weeks off work, the di­vorced 55-year-old is now wait­ing ta­bles again. She strug­gles to pay for drugs that con­trol her high blood pres­sure, high choles­terol and hy­per­glycemia.

Ash­baugh wants Brown­back to know that Med­i­caid ex­pan­sion would be smart for the state. “A lot of fam­i­lies can’t af­ford in­sur­ance even if they’re work­ing,” she said. “The other op­tion is to live off wel­fare and get dis­abil­ity.”

Postai, who pre­vi­ously voted for Brown­back, is baf­fled by the gover­nor’s hard­line op­po­si­tion to Med­i­caid ex­pan­sion.

“I truly be­lieve he’s a good Chris­tian man,” said Postai, who worked for many years as a Catholic hospital ex­ec­u­tive. “I thought he’d be there for the most vul­ner­a­ble peo­ple.”

Brown­back’s ad­min­is­tra­tion says ex­pan­sion would be too ex­pen­sive for a state that faces a $1 bil­lion pro­jected short­fall through June 2019. But the Kansas Hospital As­so­ci­a­tion ar­gues that ex­tra fed­eral dol­lars would rip­ple through the econ­omy, and the state would see a bud­get gain.

Postai, left, and Ash­baugh say that Med­i­caid ex­pan­sion is needed be­cause low-in­come work­ers are suf­fer­ing with­out health­care.

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