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Medicaid expansion a ‘ruse’ to fund big-city hospitals, would create 'entitlement class,' Brownback aide claims

Gov. Sam Brownback, R-Ks.
Gov. Sam Brownback, R-Ks.

A new email from an aide to Kansas Gov. Sam Brownback claims expanding Medicaid in the state would do nothing to help rural hospitals, like the one in Independence, Kan., that is now set to close.

Further, the email claims a moral objection to expanding Medicaid: it would provide a new entitlement, it says, “for able-bodied adults without dependents, prioritizing those who choose not to work before intellectually, developmentally, and physically disabled, the frail and elderly, and those struggling with mental health issues.”

The email is authored by Melika Willoughby, deputy communications director in Brownback’s office.

The memo suggests the Brownback administration is growing concerned with criticism that hospitals in rural areas are threatened by a cutoff in federal funds as part of the Affordable Care Act. So-called Disproportionate Share payments are to be reduced over time, with the hospitals balancing those cuts by treating more patients who are insured.

In states that have not expanded Medicaid, like Kansas, there are fewer insured patients to make up the difference.

Willoughby says that makes no difference in the state.

“Those who say Medicaid Expansion would save the Independence Hospital are lying,” she writes. “It wouldn’t. Instead, this Obamacare ruse funnels money to big city hospitals, creates a new entitlement class, and fails to rightly prioritize service for disabled citizens.”

The Kansas Hospital Association doesn’t agree.

“Kansas should thoughtfully consider using Medicaid expansion as an opportunity to build upon and improve our current Medicaid program,” it has written.

“The cost of caring for those who would be covered by Medicaid expansion is already being absorbed by hospitals, health care providers, businesses and other payers.”

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