Kansas City has long supported health services for people without insurance or a means to pay. This is primarily done through a health levy, or property tax, that brings in about $50 million annually. A portion of that tax will soon expire. Renewing it is now up for a popular vote this Tuesday. It’s Question 1 on the ballot. Despite all the contention around health policies and spending right now, there doesn’t appear to be much opposition to the local measure.
Initially Before Voters In 2005
The temporary health levy is a 22-cent property tax passed by voters in 2005. The lion share has gone to Truman Medical Centers, the city’s once public hospital. John Bluford, Truman’s CEO, said when that levy was first introduced, city funding to Truman had been on the decline.
“The context was one, the respective institutions lost funding from general fund,” said Bluford. “It was really a makeup, it didn’t materially increase total subsidy. It kept us whole.”
Bluford said the funding from that temporary levy, about $15 million annually, is just as critical today, nearly a decade later. A down economy and big cuts to the state’s Medicaid program have meant a lot more people unable to pay are turning to them for care.
Councilman John Sharp volunteered on the original health levy campaign and recalled his own wishful thinking at that time.
“Well in 2005 when this was put on the ballot, we had hoped there would be universal health care by now,” said Sharp.
Those hopes didn’t pan out.
What The Levy Funds
Last year, about one in ten residents sought care that was supported by the levy, according to the organizations receiving support from the levy. And not just at Truman. The levy also funds city ambulance services and area health clinics.
Councilman Sharp, who used to direct the city's ambulance program, says the levy helps ensure rapid responses to emergencies throughout the entire city.
The levy has also meant a lot to northland resident, Michelle Fowler.
She recently stopped by the small office of Northland Health Care Access off of Barry road to renew her membership in one of its programs, which connects patients with providers who’ve agreed to offer discount services.
“Every six months, you get a little piece of paper that you show doctor authorizing that you can get care,” Fowler said.
Fowler runs her own business and waits tables, but the restaurant stopped offering insurance a few years ago. Days before her individual insurance plan was supposed to kick in, her appendix burst. And with it, her health coverage. In the form of a last minute denial letter.
“It’s overwhelming,” Fowler said. “If I didn’t have anxiety before this, I did after I lost my health insurance.”
That was in 2010. Medical bills started piling up on top of daily living expenses. Fowler said discovering northland health care access was a huge relief.
“I didn’t have another option,” Fowler said. “Finding Northland Healthcare Access was just…When I got referred to the specialist and in my first appointment she told me I needed surgery, I started balling crying. Because I can’t afford surgery. And she said, ‘no I’m going to donate your surgery.’ And then I started balling even more.”
The temporary health levy provides $330,000 to Northland Health Car Access annually, about a third of its budget.
Levy Now Up For Renewal
The temporary health levy expires next year. City council members unanimously moved it to a vote in April. They chose renewing it for another 9 years, as opposed to a shorter period, in large part because of uncertainties around the Affordable Care Act and their concerns over the pace and financing of policies aimed at improving health coverage.
Truman and other supporters have since launched a formal campaign in support of the renewal. Backers include the Health Care Foundation of Greater Kansas City, which also funds health reporting on KCUR.
Mailers have been sent out. Yard signs have been put up. Fowler got involved.
Yet the measure doesn’t appear to have any organized opposition.
No Apparent Opposition But Some Still Critical
“The folks who stand to benefit are of course going to spend money to get it passed,” said Patrick Ishmael, a policy analyst with the St. Louis-based free market think tank, the Show-Me Institute.
Ishmael isn’t surprised by the lack of visible challenges to renewing the levy.
“The problem is the cost of the tax is so widely distributed, how would you get organized opposition against such a tax, how often has that really happened?” Ishmael said, adding that voters need to think hard before deciding on this. “One of my big concerns about maintaining the tax is that this is another one of those so-called temporary taxes that’s looking a lot less temporary these days. And so the question is whether or not Kansas Citians thinks that it’s the best use of these dollars given tight fiscal times, not just at the government level but at family level.”
Approval of the health levy in 2005 didn’t get widespread voter support, either.
Ishmael says problems in the health system need to be addressed at the state and national levels. Cities can’t fix this. Neither can levies.
Crosby Kemper III, head of the Kansas City Public Library and chair of the Show-Me Institute, has a different personal take. He thinks the health levy is an exception.
“I do believe the city is at least partially responsible,” said Kemper.
Even so, Kemper is deeply concerned with the city’s overall tax policies and plans. That’s something he says residents really need to question when taxes like this one come up for a vote.
“We passed a zoo tax with a nine percent vote. We passed a street car with vote of 300 hundred people,” said Kemper. “We have all these obligations. We’re building this huge tax burden and tax rate problem.”
Broken down within all of this, the temporary health levy costs the owner of a $100,000 house about $40 a year. So come Tuesday, voters in Kansas City will get to decide whether or not they think such a tax should continue for area health services.