As I See It

Expanding KanCare improves access and reduces costs

Updated: 2014-01-26T23:35:26Z


Special to The Star

Most people agree that preventive maintenance on a car helps prevent more costly future repairs. The human body is somewhat analogous, and needs regular care and preventive maintenance to avoid long-term health problems. It’s important to have a relationship with a physician who can guide you and help you prevent serious health issues. Health insurance provides that access.

Unfortunately, a large number of Kansans may continue to be left without access to health insurance. The Affordable Care Act envisioned expanding Medicaid to cover the working poor, and the Kansas Legislature soon must decide whether to make KanCare, the state’s Medicaid program, available to a group of newly eligible individuals. Some 77,920 Kansans living at or below 99 percent of the federal poverty level ($11,375 a year for a single person) do not qualify for subsidies in the health care marketplace. Another 91,080 adults between 100 and 138 percent of poverty who cannot afford to buy health insurance even with a subsidy also would be eligible for Medicaid. Failing to expand KanCare would leave about 169,000 Kansans with no ability to get health insurance and exclude them from access to preventive and primary care services.

Expanding KanCare makes good economic sense. Some $800 million in federal dollars would pay 100 percent of the cost for the first three years and 90 percent after 2016. The expanded population could be modified in the future if state funding becomes a problem. In the meantime, the state would benefit economically, and poor Kansans would have access to more care.

Anticipating that millions of uninsured individuals would obtain health insurance, the federal law cut reimbursements to hospitals nationwide by $155 billion over 10 years. Those cuts have been implemented, but Kansas Medicaid has not been expanded. This has a detrimental effect on hospitals and the state’s health system.

Shawnee Mission Medical Center treats about 52 percent of the uninsured population in Johnson County. Uninsured patients represent about 7 percent of our system’s patients, and Medicaid covers 7.68 percent of all hospital services. Reducing our uninsured patient population by expanding KanCare would help offset about one-third of the $ 5.6 million in federal cuts to our system annually.

The emergency room is an expensive place to deliver care, and it’s costly for both the uninsured person and for the health care system. If you have health insurance and access to a physician, a minor problem can be taken care of quickly and less expensively. A little bit of preventive medicine will go a long way to reduce emergency room use and the overall cost of care.

KanCare was created to increase the financial viability of Kansas Medicaid and to manage costs and benefits more effectively. As with any new program, KanCare has faced some challenges, and the state has worked to address them. The intent of KanCare — to deliver the right care at the right time in the right place — is good, and already is producing cost savings for the state and improving health care for program enrollees.

I believe KanCare is a viable model worthy of expansion regardless of how you feel about the ACA, and I believe Kansas should get the full benefits of federal funds. Most importantly, I want people without health insurance to have access to care so they can improve and manage their health, which will lower costs. Ultimately, that benefits society and our state.

Ken Bacon of Overland Park is the president and chief executive officer of Shawnee Mission Medical Center and the CEO of the Mid-America Region of Adventist Health System.

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