Holding Medicaid expansion in Kansas hostage to abortion amendment could be deadly

I am a physician, not a politician. While I may not understand the intricacies of amending a state constitution, I do understand the impact that the proposed abortion amendment that was defeated in the Kansas House of Representatives last week would have had on my patients.

The legislation would have allowed Kansas to impose restrictions on abortion care that the state Supreme Court ruled unconstitutional last year. When it failed, I felt a wave of relief for women across our state. However, this relief quickly ended when Kansas Senate President Susan Wagle stated that she would not take up Medicaid expansion until the amendment is passed.

Time and again, Medicaid expansion has been shown to reduce maternal mortality rates and improve overall health outcomes. It is supported by major medical organizations such as the American Medical Association and the American College of Obstetrics and Gynecology.

My patients should not be pawns in Wagle’s political game. Health care access for hundreds of thousands of Kansas should not be held captive. The best thing we can do for our pregnant mothers is to ensure that they have health care prior to getting pregnant. We cannot improve our state’s shamefully high maternal mortality rate unless we improve the health of women before pregnancy.

Perhaps Wagle and other state lawmakers pushing the amendment should take some time to meet the patients who will be impacted by their gamesmanship as they sprint through their political decision making. I’ll tell you about one of my patients, whom I’ll call Amanda to protect her privacy. Amanda managed to schedule time away from her three jobs to be able to see me one morning. Several years ago, she had gotten an abnormal result from a pap smear, but lost her health insurance and was unable to afford a follow-up visit with a doctor.

By the time I saw her, Amanda had developed invasive cervical cancer. She was also 14 weeks pregnant. As a physician specializing in high-risk pregnancies, I know the treatment for a cancer this advanced requires the termination of a pregnancy, because a fetus cannot continue developing amid the chemotherapy and radiation. We talked about what a pregnancy with cancer looked like. The risks of delaying treatment would include not only a significant decrease in her life expectancy, but also the incredibly real threat of an extremely pre-term delivery with severe consequences for the baby.

She told me that her children, one still in grade school, begged her to have an abortion so that their mother might live to see them graduate high school.

No matter their stories or their reasons, all of my patients have one thing in common: Their health care is always a personal decision, and not one to make lightly. I saw Amanda in the hospital months later, where she was receiving one of her many cancer treatments. Her cancer had run unchecked for years before diagnosis, and it breaks my heart knowing that access to health care that Medicaid expansion would bring could have prevented her from going through this agonizing experience.

To hold hostage Medicaid expansion that would give Kansans lifesaving health care is unfathomably cruel. As a physician, I was taught that all patients deserve evidence-based care, regardless of their ability to pay.

Not once has politics come up in my exam room. I ask the same from Senator Wagle.

This story was originally published February 14, 2020 at 5:00 AM with the headline "Holding Medicaid expansion in Kansas hostage to abortion amendment could be deadly."