Possible shutdown of Topeka hospital renews Medicaid expansion debate in Kansas

April 18--The possible closure of a hospital down the street from the Capitol has renewed calls to expand Medicaid in Kansas, even though lawmakers earlier failed to overcome Gov. Sam Brownback's opposition and seem unlikely to be able to do so anytime soon.

Brownback said in a statement Tuesday morning that he had been told by Mike Slubowski, CEO of SCL Health, which owns the St. Francis Health Center in Topeka, that they would not announce the closure of St. Francis on Tuesday "and that they would work with us to find a solution that keeps St. Francis open."

But in a statement Tuesday afternoon, SCL Health said that with or without a new owner, it will stop operating the hospital this summer.

If St. Francis closes, it would leave Topeka with Stormont Vail as the only community hospital, according to the Kansas Hospital Association.

"It would be devastating," said state Rep. Fred Patton, a Topeka Republican. "Not only do we not have adequate hospital space to withstand St. Francis closing, but the economic impact of 1,600 employees losing their jobs and what comes along with that would not be good at all."

In the announcement Tuesday, SCL Health said St. Francis has struggled financially and lost $117 million over the last five years, while "the number of patients has dramatically decreased."

"Additionally, without expanded Medicaid coverage and other challenges related to public programs, St. Francis experienced added pressure," the company said in its statement.

But others contend that Medicaid expansion could only be a Band-Aid to financially troubled hospitals facing closure.

Asked whether the hospital closing would change his vote against Medicaid expansion, Rep. Dan Hawkins, a Wichita Republican, said "absolutely not."

"Medicaid expansion is not going to solve the woes of that hospital," Hawkins said. "It's being used as great political folly to further the Medicaid expansion narrative. But in the end, Medicaid expansion is not going to stop the decline of hospitals."

Under the Affordable Care Act, also known as Obamacare, states can expand Medicaid to more low-income people. Expansion supporters were reluctant to say expanding KanCare, the state's privatized Medicaid program, would have solved the hospital's woes.

But they did say it could have helped the hospital find a buyer, a new owner and possibly keep it from closing.

"If this is happening in Topeka, this could happen to our city, our area," said Sen. Barbara Bollier, a Mission Hills Republican and retired physician.

Similar concerns were raised back in 2015 when Mercy Hospital in Independence, Kan., closed. Since then, lawmakers have succeeded in passing Medicaid expansion but have seen it rejected by the governor. The issue looked to be on the back burner until public uncertainty over the Topeka hospital's future rekindled the debate earlier this month.

The bill Brownback vetoed in March would have expanded Medicaid to roughly 150,000 people in Kansas. Some Republicans who pushed for expansion did so because they said the expanded healthcare could help bring money to struggling hospitals in the state.

That argument wasn't enough to satisfy Brownback and conservatives, who were able to sustain his veto in the House earlier this month.

But expansion supporters still have not backed away from the issue.

House Minority Leader Jim Ward, a Wichita Democrat, said he was already preparing to renew the expansion push when the Legislature returns on May 1.

Ward also said he was willing to tweak the bill by making it clear that no money from Medicaid expansion will go towards abortion and including work requirements in hopes of getting enough votes to override a veto from the governor.

He said the potential closure of St. Francis should be a "wake up call," for lawmakers who opposed expansion earlier this year.

"When do my ideological Republicans put their ideology aside to deal with reality?" Ward said.

Lawmakers would likely have to start from scratch if they want to try to pass Medicaid expansion. Brownback's veto of the bill in late March and the failed effort to override it effectively killed the legislation.

The effort to override Brownback's veto never made it to the Senate because it fell three votes short in the House.

But the news about St. Francis did not convince other lawmakers who voted against expansion.

"Medicaid expansion is not a cure all," said Rep. Abraham Rafie, a radiologist and Republican from Overland Park who voted against expansion. "....It won't solve all of our problems. It won't even come close."

Sen. Larry Alley, a Winfield Republican, said this week he still opposes the expansion effort because of the state's financial issues. He added that lawmakers "don't have a silver bullet to solve the issues with all of our hospitals."

"We need to solve Kansas' problems or Kansas is going to be in the same problem St. Francis is in," Alley said.

Hunter Woodall: 785-354-1388, @HunterMw

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