Matt Hodapp / KCUR

Democrat Missouri Rep. Jeremy LaFaver from District 025 provides an insider perspective on the Missouri General Assembly as we discuss legislative term limits, Planned Parenthood, and Medicaid.


  • Jeremy LaFaver, Rep. from District 025, Missouri General Assembly 
  • Meredith Adams, Citizen
  • Cody Newill, General Assignment Reporter, KCUR

Kansas’ decision to not expand Medicaid is putting health care providers in jeopardy, the head of the state’s largest health system said Wednesday.

Jeff Korsmo, CEO of Wichita-based Via Christi Health, issued a statement calling on Gov. Sam Brownback and Republican legislative leaders to drop their opposition to expanding KanCare, the state’s privatized Medicaid program.

Mercy Hospital Independence

The scheduled closure of the only hospital in the southeast Kansas community of Independence could create new urgency around the Medicaid expansion debate.

Advocates of expanding the Kansas Medicaid program — known as KanCare — say the additional federal money it would generate would help stabilize a growing number of struggling hospitals in the state and might have helped save Mercy Hospital Independence.

Susie Fagan / Heartland Health Monitor

Editor's note: This story was updated on Sept. 1 to include the response of the CEO of Lawrence Memorial Hospital.

A former emergency room nurse at Lawrence Memorial Hospital has filed a federal “whistleblower” lawsuit alleging that the hospital falsified patient records to obtain higher Medicare and Medicaid payments.

The lawsuit filed in U.S. District Court in Kansas City, Kan. on behalf of Megen Duffy alleges that top hospital officials knew about the fraud, which began in 2007, and threatened to fire employees who objected.

Andy Marso / Heartland Health Monitor

Cabinet officials say Kansas’ quest to combine Medicaid waivers for people with seven categories of disabilities is intended to provide better care and outcomes, not cost savings.

But costs will go down if care improves as intended, they say.

Officials from the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services are beginning a statewide listening tour on the proposed changes after briefing a legislative committee on them Friday.

Dave Ranney / Heartland Health Monitor

Kansas officials are reviewing a recent federal appeals court ruling that requires the state’s Medicaid program to pay in-home care workers minimum wage and overtime.

Officials at the Kansas Department of Aging and Disability Services issued a statement shortly after the ruling was handed down Friday saying they were attempting to determine its “potential impact” on the state’s Medicaid program, known as KanCare.

Dave Ranney / KHI News Service

  The head of the Kansas Hospital Association is taking issue with comments made by Gov. Sam Brownback at a recent news conference.

Asked about his continuing opposition to Medicaid expansion, Brownback downplayed the importance of the issue, telling reporters that innovation is more important to hospital finances than the billions of additional federal dollars that expansion would provide.

Matt Hodapp / KCUR

Republican Missouri Rep. Joe Don McGaugh from District 039 provides an insider perspective on the Missouri General Assembly as we discuss agriculture, education, and Medicaid expansion.


  • Joe Don McGaugh, Rep. for District 039, Missouri General Assembly 
  • Arley Hoskin, Citizen Voice
  • Mike McGraw, Special Projects Reporter, Flatland KC
Executive Office of the President of the United States

Advocates of government-sponsored health care gathered Thursday at the Harry S. Truman Library and Museum in Independence, Missouri, to mark the anniversary of legislation that’s both a local story and a milestone for medical care in the United States.

Fifty years ago, on the same stage where speakers sat, President Lyndon Johnson signed the law establishing Medicare and Medicaid, vastly expanding insurance protections for the elderly and for low-income Americans.

Andy Marso / Heartland Health Monitor

Gov. Sam Brownback said Friday he’s unconvinced Medicaid expansion is an answer to the financial woes of rural Kansas hospitals and suggested they should innovate instead.

During a news conference Friday, Brownback was asked about a Reuters story on the improving financial fortunes of public hospitals in states that expanded Medicaid under the federal Affordable Care Act versus the stagnation of hospitals in states that did not.

Jim McLean / Heartland Health Monitor

Editor's note: This is the second of two stories looking at Medicaid expansion in Missouri and Kansas. Today's story looks at the failure to expand Medicaid in Kansas. Wednesdays story looked at the failure to expand Medicaid in Missouri. Tonight, Thursday, at 7:25 p.m., KCPT Channel 19 will air a video tied to the stories. 

  The Kansas Hospital Association and other groups urging Kansas lawmakers and Kansas Governor Sam Brownback to expand Medicaid coverage to more poor adults have little to show for their three years of lobbying on the issue.

Truman Medical Centers

Editor's note: This is the first of two stories looking at Medicaid expansion in Missouri and Kansas. Today's story looks at the failure to expand Medicaid in Missouri. Tomorrow's story will look at the failure to expand Medicaid in Kansas. On Thursday at 7:25 p.m., KCPT Channel 19 will air a video tied to the stories. 

It’s a sweltering Monday afternoon, and in the emergency room of Truman Medical Centers near downtown Kansas City, a patient complains of excruciating abdominal pain.

The attending physician advises her there’s only so much he can do.

Andy Marso / Heartland Health Monitor

One of the leading advocates for Medicaid expansion in Kansas says it’s time to change tactics.

This week Alaska became the 30th state to expand Medicaid under the federal Affordable Care Act. Kansas is one of the remaining states where Republican legislators and governors remain resistant.

Mike Sherry / Heartland Health Monitor

Advocates for expanding Medicaid coverage to more low-income Americans must refine their strategies to win over lawmakers in states such as Missouri and Kansas, which have resisted efforts to loosen eligibility requirements.

That was the message Saturday during a panel discussion at the National Council of La Raza annual conference, which is being held at the Kansas City Convention Center.

“I would say it is going to take more than what we have been doing,” said Laura Guerra-Cardus, associate director of the Children’s Defense Fund in Texas.

Financial disclosures aren’t just for political candidates. New data released by the Centers for Medicare and Medicaid Services shows that Missouri doctors received at least $71.9 million from medical device and drug companies in 2014 and the latter half of 2013. Illinois doctors pulled in $104 million during that same time period, many of whom hail from the Chicago area.  

Bryan Thompson / Heartland Health Monitor

A lot of the hospitals in rural Kansas are called “Critical Access Hospitals.” It’s an important designation, because Critical Access Hospitals were created by the federal government to maintain access to health care in rural areas.

But Many Kansas Critical Access Hospitals are in financial trouble. Medicare requires them to offer 24-hour emergency services. But most don’t have enough ER patients to justify the cost of 24-7 service, says Melissa Hungerford, senior vice president for health care leadership at the Kansas Hospital Association.

The Kansas Health Consumer Coalition will cease operations this week.

“It’s been a struggle to maintain our funding,” said Carol Ramirez Albott, president of the Topeka-based advocacy group’s governing board. “Things just got to a point where we felt like we couldn’t adequately do the job.”

The board, she said, notified its supporters of the decision late last week.

Attorneys general in 10 states, including Kansas, have asked a congressional committee to investigate efforts by the Obama administration to “coerce” states to expand their Medicaid programs by withholding unrelated healthcare funds.

Jim McLean / Heartland Health Monitor

Legislators locked in increasingly tense discussions about how to balance the budget and end the longest legislative session in Kansas history said there is no longer any serious talk about expanding Medicaid eligibility this year.

“Given all the time we’ve wasted, it is incredibly disappointing that we couldn’t find the time to deal with this issue,” said Rep. Jim Ward, a Wichita Democrat and the Legislature’s most vocal advocate of expansion.

Kansas Governor Sam Brownback’s determination to not expand Medicaid in his state remains strong. On this edition of Up To Date, journalist Kai Wright discusses his recent article for The Nation, which examines the effects the governor's policy on Kansas residents and medical professionals. 

Andy Marso / Heartland Health Monitor

Frustrated by their inability to muster more than a handful of votes for any tax plan, Kansas Republican legislative leaders are asking rank-and-file members the “What will it take to get out of here?” question.

They’re getting a variety of answers as the session, on its 103rd day, inches closer to record territory as the longest in state history. In 2002, legislators met for 107 days.

A Senate committee on Thursday learned that a bill proposing that the state collect a 3.5 percent fee on health insurance policies sold to Kansans on the federal government’s online marketplace could be used to force a vote on Medicaid expansion.

“I want to know if Senate Bill 309 could be a vehicle for Medicaid expansion,” Sen. Laura Kelly, a Topeka Democrat, asked in the final minutes of the Senate Ways and Means Committee hearing.

KHI News Service photo

Some legislators are considering the possibility of eliminating the state’s earned income tax credit in exchange for expanding its Medicaid program.

“That’s being shopped around, big time,” said Sen. Laura Kelly, a Topeka Democrat.

“There’s been discussion of that, yes,” said Rep. Don Hill, an Emporia Republican.

Kelly and Hill, who serve on their respective chambers’ health and budget committees, declined to say which legislators are promoting the would-be deal.

Mercy Hospital, Independence

At the beginning of the 2015 legislative session, Kansas hospital administrators signaled their willingness to talk about increasing a state assessment on their revenues to fund Medicaid expansion.

They anticipated that the state’s deteriorating budget situation would make it impossible for Gov. Sam Brownback and Republican legislative leaders to consider expansion without a way to pay for the state’s share of the costs.

And they anticipated that even with funding options, Medicaid expansion was a long shot to pass.

Supporters say they still hope to force floor votes on an expansion bill, although Brownback and legislative leaders remain opposed to it.

But it’s clear that hospital officials didn’t anticipate the turn of events that has put them on the defensive in the final weeks of the session.

Brownback and key lawmakers are now talking about raising the provider assessment. But they see it as a way to help balance the budget rather than fund a Medicaid expansion plan.


Gov. Sam Brownback on Monday announced that Kansas would file a brief supporting Florida Gov. Rick Scott’s lawsuit against the federal government over Medicaid expansion.

The Center for Medicare and Medicaid Services recently warned Florida, Kansas and Texas that failing to expand Medicaid under the Affordable Care Act could jeopardize special funding to pay hospitals and doctors for treating the poor.

Bryan Thompson / Heartland Health Monitor

There are a lot of small, rural hospitals in Kansas. Without them, many Kansans would have to travel long distances for care. What’s more, in many small towns, the hospital is one of the largest employers — making it vital to the local economy.

But declining populations, combined with changes in the way hospitals are paid for their services, are making it more difficult for many small hospitals to survive.

There is at least one hospital in 96 of the state’s 105 counties, according to Melissa Hungerford, senior vice president for health care leadership at the Kansas Hospital Association and chief executive officer of the Kansas Hospital Education and Research Foundation.

The stakes for Kansas to expand Medicaid have been raised.

The state received notice from the Centers for Medicare and Medicaid Services last week that if it doesn’t expand its Medicaid program, it would lose federal funding for uncompensated health care, according to officials from the Kansas Department of Health and Environment.

The federal government provides money for the state’s uncompensated care pool to reimburse health care providers who serve the uninsured.

AP Photo

The public should expect to see significant evolutions in Medicare and Medicaid in coming years, a national health care expert told a Kansas City audience Friday.

Genevieve M. Kenney of the Urban Institute said an inevitable component of Medicare’s need to save money will be talk about raising the eligibility age. The current age of eligibility is 65, but life expectancy has increased since enactment of the program 50 years ago.

Chris Potter /

Missouri claimed nearly $35 million in unallowable Medicaid reimbursements after failing to comply with requirements under Medicaid’s drug rebate program, an audit released Tuesday found.

All 50 states and the District of Columbia cover prescription drugs under the program, which helps offset the costs of outpatient prescription drugs for Medicaid patients.

A conference committee agreed Wednesday to adopt a budget bill that cuts $378,000 from a grant program that supports safety net clinics throughout Kansas.

“We’re greatly disappointed,” said Denise Cyzman, executive director of the Kansas Association for the Medically Underserved, an organization that represents the 43 safety net clinics in Kansas.