Several dozen people, including local legislators, commissioners and health and nonprofit representatives, gathered, fittingly, in the basement of St. Catherine Hospital Tuesday night to listen and ask questions about one topic: the expansion of Medicaid in Kansas.

The Alliance for a Healthy Kansas’ evening forum was the third local event — the first two included a tour of St. Catherine and a drop-in at the Garden City Area Chamber of Commerce meeting — for Lieutenant Governor Lynn Rogers, who is in the midst of a tour to more than a dozen rural hospitals in the state. What he’s found is that each hospital is different, he said, but that “Medicaid expansion would help absolutely every one.”

“(Medicaid expansion) was one of our major campaign promises … and I think that’s one of the reasons we won, people wanted us to deal with Medicaid expansion. We see how important this is to get done now … We really have an economic imperative for doing this, but we also have a moral imperative for doing this as well,” Rogers said.

Medicaid, or KanCare, expansion would make health insurance a possibility for 80,000 low-income Kansans who make too much money to qualify for the service now, but too little to qualify for marketplace subsidies, said April Holman, executive director of the Alliance for a Healthy Kansas. According to a handout, those residents include nearly 1,600 people in Finney County and about 5 to 9 percent of adults in southwest Kansas counties.

The reach could potentially be greater than that, Holman said — the efforts to expand the service could lead to the coverage of another 70,000 people statewide through children without access or adults who already qualify.

The expansion, supported, said Sen. John Doll, I-Garden City, by Democrat and moderate senators and opposed largely by some Republicans, has been opposed out of concern it would simply add to state debt, Holman said.

The federal government will cover 90 percent of the costs, she said. Kansas is one of 14 states who have not yet opted in to expansion.

The expansion would hold significant economic ramifications for the state, especially rural areas. Eighty-five percent of state hospitals are not making or losing money each year and nearly 25 percent oare in seriously precarious financial positions, largely due to millions of dollars in care that patients can’t afford to pay, Rogers said in a separate interview.

In rural areas, that means hospitals must drop services, sometimes vital ones like birthing, to stay afloat. That places added strain on patients, who are now far away from needed care.  Area hospitals must pick up the slack. Rogers said hospitals, like schools and housing, are essential services that make it possible to draw or recruit people to communities, and without them, rural areas struggle. If the hospital closes, the community it served feels the harsh impact.

Insurance itself has a similar impact, said Sister Janice Thome of the Dominican Sisters of Peace, one of the night’s speakers. Many local childcare workers do not have medical insurance, she said. She said if they leave or change professions, the area’s already limited childcare suffers and people are less inclined to move to the area. The healthcare issue also becomes a workforce one.

The expansion puts nearly $700 million of federal tax dollars into the state, Holman said, and could result in as much as 3,800 new jobs.

And it would provide much needed medical access, speakers said. Thome told stories of a man who died after putting off going to the emergency room in the attempt to avoid adding to he and his family’s medical debt and another who pays $400 a month to include his wife under his employer health insurance.

Lisa Southern, executive director of Compass Behavioral Health, said the policy change would have effects on the medical health field, as well. Many people with limited funds will neglect their mental health for their physical health, she said. Others will neglect their physical health, from refilling or changing prescriptions to attending dialysis, and suffer mental health problems as a result. As suicide rates, especially among young people, continue to rise, access to mental and behavioral health medication and treatment cannot be overlooked, she said.

Expanding Medicaid is an inevitability in Kansas, Rogers confirmed in a separate interview. It passed the legislature in 2017, only to be vetoed by Gov. Sam Brownback. A new attempt has passed the House and sits in committee in the Senate, essentially being delayed by leadership, Holman and Doll said.

Doll said it will likely only move forward with work requirements to those that take advantage of it, a controversial addition in itself since about a third of those in the gap, some of whom are disabled or caretakers, are limited in how much they can work. Delaying the bill is silly, Rogers said.  He said it will only cost hospitals more money.

As he said at the forum, the solution was an old one: write, email, call your representatives and senators. And if that doesn’t work, vote them out.

Contact Amber Friend at afriend@gctelegram.com.