The Joplin Globe, Joplin, MO


May 20, 2013

Herb B. Kuhn, guest columnist: Delaying Medicaid reform could hurt rural Missouri

JEFFERSON CITY, Mo. — The Missouri Legislature missed a rare opportunity in the just-ended session to transform Medicaid and make a real difference in the lives and health of hundreds of thousands of our neighbors. Rural Missouri has the most to lose from the legislature’s failure to act.

Health care choices are more limited in rural areas, which means there is tremendous dependence on the facilities and dedicated professionals providing care. The local hospital is not only essential for medical services, it is often the largest employer in a rural community. National studies show that on average, 14 percent of total employment in rural communities is in the health sector. Quality rural health services are critical to attracting and retaining businesses, industries and new residents, as well as retirees.

Rural Missouri will be subject to disproportional distress from Medicaid inaction because so many people rely on relatively few facilities and providers. In recent years, Missouri’s rural hospitals handled one-third of all emergency room visits, nearly 40 percent of the state’s inpatient admissions, a quarter of all childbirths and 28 percent of all heart attack victims. Studies show rural Missourians have more chronic diseases than their urban counterparts, and decreased availability of care can be life-threatening. The legislature’s failure to act means there will be real pain for both the uninsured and for those relying on medical services that are now subject to severe cuts or elimination.

Already, Missouri health care providers are assessing areas in which to reduce or eliminate services because of federal funding shortfalls caused by this year’s inaction in Jefferson City. It will be an anxious summer that has implications for a grim fall and winter.

For example, Heartland Health in St. Joseph has alerted local officials that without additional enrollment of individuals through Medicaid reform, it can no longer subsidize $1.7 million a year in ambulance losses and will discontinue its ambulance services.

Hospitals’ uncompensated care costs will continue to grow unsustainably. In 2011, Missouri hospitals provided $1.1 billion in uncompensated care. These costs are projected to rise to more than $3.5 billion per year by the end of the decade without Medicaid reform. In the federal budget year that starts Oct. 1, hospitals will face significant losses through payment cuts from Medicare and Medicaid without new revenue from Medicaid reform meant to offset those cuts. This will remove the opportunity for growth in both the health sector and throughout the economy, and it will weaken hospitals’ ability to provide the services our communities deserve and depend on.

The House and Senate have indicated they will establish interim committees to study Medicaid during the next few months before the legislature reconvenes in January 2014. We are determined to carry out the public discussion necessary to prepare for legislative action next year. Between now and then, we will continue to build partnerships and educate all parties about the necessity of and the opportunity presented by Medicaid reform. The needs and the stakes are too serious for inaction. Inaction is not an option.

Lawmakers, health care providers and all Missourians need to focus on what we can accomplish. By next year, we can — and we must — build a better Medicaid system for Missouri.

Herb B. Kuhn is president and CEO of the Missouri Hospital Association in Jefferson City.

Text Only
  • Our View.jpg Our View: Too many questions on No. 5

    Even though the Second Amendment to the U.S. Constitution guarantees “the right of the people to keep and bear arms,” Missouri voters on Aug. 5 are being asked to consider an amendment that restates that freedom and then goes even further.

    July 31, 2014 1 Photo

  • Your View: Beware the wolf

    The wolf (the Humane Society of the United States, People for the Ethical Treatment of Animals and other radical animal rights organizations) has conned Little Red Riding Hood (the Missouri Rural Crisis Center, The Joplin Globe editorial staff and, as of last week, the local Democratic leadership).

    July 31, 2014

  • Your View: Dally for Division 5

    I have known Nate Dally almost my entire life. As we grew up, Nate always had a strong passion and desire to make sure everyone was treated fairly and equally.

    July 31, 2014

  • Your View: Vote ‘no’ on 7

    The Globe has been on my reading list for over 35 years, and during that time the Globe has frequently supported tax increases. Same thing again in the Sunday, July 27, editorial, “‘Yes’ on 7.”

    July 31, 2014

  • Geoff Caldwell, columnist: An America transformed

    On Oct. 30, 2008, Barack Obama boldly declared: “We are five days away from fundamentally transforming the United States of America.”

    July 30, 2014

  • Other Views Other Views: Open the primaries

    Missourians will go to the polls in the Aug. 5 primary.

    July 30, 2014 1 Photo

  • Your View: ‘Right to Farm’ is wrong

    On Aug. 5, voters will be asked to make a decision about Amendment 1.

    July 29, 2014

  • Your View: No on Amendment 7

    The Missouri Department of Transportation is wanting more money through a three-quarter-cent addition to the sales tax. Consider one example of how it spends your money.

    July 29, 2014

  • Your View: Bad way to get revenue

    I received two fliers through the mail today asking me to vote “yes” on Amendment 7, which would add a three-quarter-cent tax to Missouri’s sales tax to help maintain roads and bridges.

    July 29, 2014

  • Our View.jpg Our View: No need for No. 9

    “Shall the Missouri Constitution be amended so that the people shall be secure in their electronic communications and data from unreasonable searches and seizures as they are now likewise secure in their persons, homes, papers and effects?”

    July 29, 2014 1 Photo

Local News
Twitter Updates
Follow us on twitter

Missouri's sales tax-free weekend begins Friday. Do you plan purchases around this weekend?

A. Yes.
B. No.
     View Results
NDN Video
Couple Channel Grief Into Soldiers' Retreat WWI Aviation Still Alive at Aerodrome in NY Raw: Rescuers at Taiwan Explosion Scene Raw: Woman Who Faced Death Over Faith in N.H. Clinton Before 9-11: Could Have Killed Bin Laden Netanyahu Vows to Destroy Hamas Tunnels Obama Slams Republicans Over Lawsuit House Leaders Trade Blame for Inaction Malaysian PM: Stop Fighting in Ukraine Cantor Warns of Instability, Terror in Farewell Ravens' Ray Rice: 'I Made a Huge Mistake' Florida Panther Rebound Upsets Ranchers Small Plane Crash in San Diego Parking Lot Busy Franco's Not Afraid of Overexposure Fighting Blocks Access to Ukraine Crash Site Dangerous Bacteria Kills One in Florida Workers Dig for Survivors After India Landslide Texas Scientists Study Ebola Virus Smartphone Powered Paper Plane Debuts at Airshow Southern Accent Reduction Class Cancelled in TN