A patient and a provider explain why Kansas should expand Medicaid

In vetoing a bill to expand Medicaid coverage to an estimated 150,000 low-income adults, Kansas Gov. Sam Brownback said that Medicaid should include a strict requirement that all able-bodied adults find a job. “We cannot help our citizens build better lives without also incentivizing them to find a permanent path out of poverty,” he wrote.

But Krista Postai, CEO of the Community Health Center of Southeast Kansas, said that's the wrong way to look at the issue. Her clinic treats many working people who don't seek preventive care because they lack insurance and can't afford to pay for healthcare.

“We have people working three jobs with no coverage,” she said. “If you want to maintain a healthy workforce, they need to have preventive care.”

Laura Ashbaugh gets paid $200 a week waiting tables at a diner in Cherokee, Kan., in the impoverished southeast corner of the state. In late 2015, she was diagnosed with a large kidney stone that required surgical removal. But she has no health insurance.

So Ashbaugh worked through the intense pain until October, when she finally was able to get an operation through a charity-care program. After eight weeks off work, the divorced 55-year-old is now waiting tables again. She struggles to pay for drugs that control her high blood pressure, high cholesterol and hyperglycemia.

Ashbaugh wants Brownback to know that Medicaid expansion would be smart for the state. “A lot of families can't afford insurance even if they're working,” she said. “The other option is to live off welfare and get disability.”

Postai, who previously voted for Brownback, is baffled by the governor's hardline opposition to Medicaid expansion. “I truly believe he's a good Christian man,” said Postai, who worked for many years as a Catholic hospital executive. “I thought he'd be there for the most vulnerable people.”

Brownback's administration says expansion would be too expensive for a state that faces a $1 billion projected shortfall through June 2019. But the Kansas Hospital Association argues that extra federal dollars would ripple through the economy, and the state would see a budget gain.