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00000179-cdc6-d978-adfd-cfc6d7d40002Coverage of the issues, races and people shaping Kansas elections in 2016, including statewide coverage in partnership with KCUR, Kansas Public Radio, and High Plains Public Radio.

Hospital Closure Has Some Southeast Kansas Candidates Rethinking Medicaid Expansion

Mercy Hospital Independence
Mercy Hospital before it closed in August 2015.

Knocking on doors in southeast Kansas, as elsewhere in the state, candidates get an earful about public school funding and the state’s budget mess, first and foremost. So it’s hard to know how much the local hospital’s closure factored into the defeat of two of the area’s longtime Republican legislators in the primaries. But it is clear health care is at the top of the mind for the candidates left standing.

A large section of what used to be Mercy Hospital in Independence, Kansas, has been torn down in the year since it closed.

Credit Jim McLean / KHI
A large portion of Mercy Hospital in Independence has been torn down since its closure in the fall of 2015. A garage for city emergency vehicles is being constructed in its place.

On a hot August day, a bulldozer is prepping the lot where it once stood for the construction of a new city garage.

Andy Taylor, the editor of the weekly Montgomery County Chronicle, says many residents of the community of about 10,000 still aren’t sure exactly what happened. But he says they believe city and state officials could and should have done more to save the hospital.

“What the average citizen knows is there’s not a hospital here,” Taylor says. “The day in August of 2015 when Mercy Health System said we’re closing this hospital, people woke up, and they said, ‘OK, elected officials, where were you?’”

As it turns out, several area lawmakers were among those who, with Gov. Sam Brownback and Republican legislative leaders, blocked something that might have helped: Medicaid expansion.

“The refusal to expand Medicaid is part of the reason (the hospital closed),” says Chuck Schmidt, a Democrat running for the seat being vacated by Republican Sen. Jeff King of Independence.

“We know that hospital lost $1.6 million a year as a result of not having Medicaid expansion,” Schmidt says, referring to the amount the hospital would have gained in higher reimbursements under expansion.

Two area lawmakers who were vocal opponents of expansion were defeated in the August primary election. Rep. Virgil Peck, a conservative Republican from Tyro, lost his bid for an open Senate seat to Dan Goddard, a retired businessman from Parsons. Sen. Forrest Knox, of Altoona, an 11-year legislative veteran, was defeated by Bruce Givens, an educator from El Dorado.

Credit Jim McLean / KHI
Montgomery County Chronicle editor Andy Taylor works near a copy of the front page of the paper reporting the closure of Mercy Hospital in Independence. Taylor says area voters are holding elected officials accountable for the hospital’s closure.

Both Peck and Knox were supporters of Brownback’s tax cuts. Those cuts, and the budget problems that followed, were, Taylor says, the main reasons for their defeat. But he says Peck’s perceived inaction on the hospital issue also was a factor.

“The hospital was in his district,” Taylor says. “And he said absolutely nothing to help the situation.”

Even with Kansas hospital administrators calling for the expansion of KanCare, the state’s privatized Medicaid program, candidates must approach the issue with care because of its connection to the Affordable Care Act, the federal health reform law that many in this part of the state still derisively refer to as Obamacare.

The campaign card that Schmidt gives to voters when he goes door-to-door doesn’t mention expansion and the fact that it would provide health coverage to tens of thousands of low-income Kansans. Instead, it says he supports “quality rural healthcare.”

Schmidt says other area hospitals could be at risk without the additional federal dollars expansion would provide.

“Labette County hospital is losing $3 million a year, now, and Coffeyville is losing $2 million,” he says, noting that Neosho Regional Medical Center in Chanute would be getting an additional $2.5 million a year under expansion.

“Those are significant numbers,” he says. "If we don’t get turned around and get Medicaid expansion we could have other hospitals close as well.”

To date, the Kansas Hospital Association estimates the rejection of expansion has cost the state nearly $1.4 billion in additional federal funds.

It’s not just Democrats who are now amenable to expansion. Goddard, Schmidt’s GOP opponent in the general election, favors it.

Credit Jim McLean / KHI
Doug Blex, Republican candidate for the Kansas House, talks with Andy Taylor, editor of the Montgomery County Chronicle, about how the closure of Mercy Hospital in Independence is affecting 2016 legislative races.

Doug Blex is the conservative Republican running for Peck’s old House seat. A retired state employee who now ranches near Independence, Blex says he was initially skeptical of Medicaid expansion as another program that he doesn’t believe the debt-strapped federal government can afford.

“Quite frankly before the shock of the hospital hit me, I was leaning against it,” he says.

But the “shock” of seeing the hospital where he and his children were born close caused him to rethink his position. Now, after “a lot of discussion with other people” he’s concluded that expansion isn’t all that different from other federal programs important to rural America.

“Farmers get federal subsidies,” he says. "And if it takes a federal subsidy (to stabilize rural hospitals), and it’s not costing Kansans a lot of money, I’m leaning to probably support Medicaid expansion.”

The ACA requires the federal government to permanently cover no less than 90 percent of the costs of expansion.

Jean Kurtis Schodorf, of Sedan, Blex’s Democratic opponent in the Nov. 8 election also favors expansion.

The emerging bipartisan support for expansion is an indication that no candidate in southeast Kansas wants to run the risk of their hospital being the next to shut its doors.