Topekan Calais Sherry, who has experienced benefits of Medicaid and consequences of not having that primary health care, said expansion of Medicaid in Kansas would improve the lives of people such as herself who receive mental health services. (Tim Carpenter/Kansas Reflector)
TOPEKA — Calais Sherry experienced how health care services delivered through Medicaid provided stability and peace of mind during her pregnancies.
Programs tied to the COVID-19 pandemic offered Sherry an unexpected lifeline to Medicaid, but that benefit expired in August. The 33-year-old Topekan’s return to life without health insurance has been challenging given her reliance on mental health services for depression. Over the years, access to health professionals through Medicaid also helped her balance payment of bills for housing, utilities and transportation.
“This is the longest I’ve been housed … on my own, paying the bills — I don’t owe anybody money. All my utilities are turned on,” she said. “When you lose your insurance, it’s not just about the money. It’s not about making your doctor’s appointments or getting your medication. It’s kind of a domino effect.”
Democratic Gov. Laura Kelly brought her campaign for Medicaid expansion Tuesday to a nonprofit behavioral health facility to raise awareness of the potential if the Legislature expanded eligibility for Medicaid to about 150,000 people. Forty states and the District of Columbia have already agreed to extend health care to millions of the working poor with the federal government paying 90% of expansion costs and states paying the rest.
“We are doing this ‘Healthy Worker, Healthy Economy’ tour to really elevate Medicaid in the minds of Kansans all over the state,” Kelly said. “It is only the Legislature that can make this happen.”
In Kansas, the House and Senate approved a Medicaid bill in 2017. It was vetoed by Republican Gov. Sam Brownback. Kelly plans to submit her sixth expansion plan to legislators in January. The Legislature’s current GOP leaders oppose bipartisan efforts to expand eligibility.
The stalemate means Kansas residents and health care providers miss an estimated $66 million in monthly government assistance for health care.
“When Kansans have health insurance, they’re more likely to get the treatment they need in a timely manner so they can continue being present and supportive members of their families and communities,” Kelly said.
Helping 24,000 adults
Andy Brown, commissioner of behavioral health at the Kansas Department for Aging and Disability Services, said expansion would deliver millions of dollars annually to community mental health programs across Kansas.
He said Kansas Health Institute reported in January that expansion of Medicaid would benefit an estimated 24,000 Kansans if the program added 108,000 adults. A separate analysis by Mental Health American indicated 18% of adults with mental illness in Kansas had no insurance compared to 11% without insurance nationwide.
In Shawnee County, state officials said, expansion would make 3,600 additional residents eligible for Medicaid. Infusion of $31 million in new annual health care spending would create an estimated 1,200 jobs within Shawnee County.
“Medicaid expansion will provide needed relief to address behavioral health issues and public safety concerns,” said Topeka Mayor Mike Padilla.
States that expanded Medicaid averaged more than 1,000 additional mental health visits at federally qualified health centers.
“We want to do our part to work with the whole health and social system to get people back up on their feet and get to recovery,” said Bill Persinger, chief executive officer of Valeo Behavioral Health Services. “If we can get Medicaid to continue to catch up, we will be able to balance our budget, move forward and continute to say ‘yes’ to everybody who comes through the door.”
Persinger said Medicaid expansion would infuse $1.5 million into Valeo, which operated on a $25 million annual budget. He said 30% of Valeo’s 6,500 clients had jobs but no health insurance.
Sherrie Vaughn, executive director of NAMI Kansas, said individuals who couldn’t secure mental health services because they were uninsured or underinsured too oftened ended up self-medicating.
“Nineteen percent of those who have a mental illness will also have a substance abuse disorder,” Vaughn said. “They also find themselves not doing well within their home with their caregivers. They find themselves exiting their home and they’re out on the streets. The next thing you see is they’re in the county jail.”
Jon Antrim, regional director for Global Medical Response, which includes more than a dozen air and ground medical transport operations in Kansas, said Medicaid expansion would relieve strain on the state’s system of first-responders.
Adding people to Medicaid would mean more Kansans had reliable access to primary medical care and wouldn’t turn so frequently to 911 services, he said.
“About 70% of the calls we run are considered no-pay or low-pay patients within the city of Topeka,” he said. “The financial impact is about $4 million worth of uncompensated care to Topeka.”
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