- Associated Press - Monday, September 21, 2015

TOPEKA, Kan. (AP) - A southern Kansas hospital’s pending closure, which administrators blame on the state’s reluctance to expand Medicaid, hasn’t been enough to persuade Gov. Sam Brownback to soften his stance on the matter.

Mercy Hospital System plans to close its hospital in Independence, near the Oklahoma border, next month. Mercy spokeswoman Joanne Smith said expanding the program that provides health coverage to poor and disabled Kansans would have brought the hospital about $1.6 million in additional revenue.

“And that’s very significant for a small hospital like ours,” she told The Wichita Eagle (https://bit.ly/1LGNcmW ).

Kansas is one of 20 states that have refused to expand Medicaid under the federal health care law. Rural hospitals already were struggling with declining populations, and, in many cases, their financial situations had become critical because of changes in the way hospitals get reimbursed under the health care law.

Cuts in Medicare and Medicaid reimbursements were designed to be offset by additional revenues from the Medicaid expansion. But when Kansas refused to expand Medicaid, its hospitals were hit especially hard.

Supporters of expanding Medicaid said they hope news of the Independence hospital closure will spur the Legislature to extend the program to 150,000 Kansans who now have no health insurance.

“I don’t think we have the resources to get it done,” Brownback told students at Hutchinson Community College last week. He said Medicaid costs have grown even without expanding the program. The federal government agreed to pay all costs for the new enrollees through 2016, but it will begin lowering its share in 2017. States will pay 10 percent of the costs by 2020.

The Kansas Hospital Association, which has repeatedly warned lawmakers that hospitals in the state were struggling because of the state’s decision not to expand its Medicaid program, has a ticker on its website showing the amount of federal money Kansas has passed up by not expanding since January 2014. It’s nearing $738 million.

“I think we figured out it’s about 12 dollars a second,” said Tom Bell, the association’s president.

Brownback said the hospital closure isn’t because the state won’t expand Medicaid. “They should blame it on Obamacare,” he said.

With a population of more than 9,000, Independence will be the largest community in the state without a hospital. The closest alternatives are in Neodesha, about 16 miles away, and Coffeyville, 20 miles away.

Rep. Sue Concannon, a Beloit Republican who is an outspoken supporter of expansion, said she worries that the Independence hospital’s closing is “just the tip of the iceberg.”

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