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Kansas' dilemma: partisan principles vs. healthcare reality

A Kansas Republican saw no need to accept Medicaid expansion through the Affordable Care Act - until his local hospital permanently closed its doors.
Kansas Gov. Sam Brownback delivers his State of the State speech to an annual joint session of the House and Senate at the Statehouse in Topeka, Kan., Jan. 15, 2014. (Photo by Orlin Wagner/AP)
Kansas Gov. Sam Brownback delivers his State of the State speech to an annual joint session of the House and Senate at the Statehouse in Topeka, Kan., Jan. 15, 2014.
Jeff King, a leader of the Republican-led state Senate in Kansas, has long been opposed to the Affordable Care Act. Indeed, like most GOP officials in Kansas, King has balked at even allowing a debate over expanding "Obamacare" in the state.
 
But Mercy Hospital in Independence, Kansas, recently announced it will permanently close its doors on Oct. 10, in large part because the state refuses to consider Medicaid expansion under the ACA. The medical facility is in Jeff King's district -- prompting him to give "Obamacare" a second look.
 
He told the Lawrence Journal-World last week that if the state could pursue a conservative approach to Medicaid expansion -- along the lines of what Indiana and other "red" states have already embraced -- it would be "something that Kansas needs to strongly consider."
 
Yesterday, the Topeka Capital-Journal reported on the response from King's ostensible GOP allies.

A southern Kansas hospital’s pending closure, which administrators blame on the state’s reluctance to expand Medicaid, hasn’t been enough to persuade Gov. Sam Brownback to soften his stance on the matter. [...] Brownback said the hospital closure isn’t because the state won’t expand Medicaid. “They should blame it on Obamacare,” he said.

As a substantive matter, this doesn't make any sense at all. The Affordable Care Act didn't cause the hospital to close; the Affordable Care Act is offering the hospital a lifeline that could keep the facility open. Brownback, who really ought to know better, has the entire story backwards.
 
The far-right governor, however, ignoring the success of the policy in most of the country, won't consider the easy, obvious solution.
 
This is going to get worse for Kansas before it gets better.
 
In fact, the Kansas Hospital Association, which has pleaded with Republican policymakers to be more responsible, has warned state officials that additional facilities may yet close for the same reason. The Topeka Capital-Journal article added that the Kansas Hospital Association has been keeping track of "the amount of federal money Kansas has passed up by not expanding since January 2014."
 
As of yesterday, the total was nearly $738 million.
 
Brownback, facing a fiscal crisis of his own making, nevertheless remains unmoved by evidence, reason, common sense, and arithmetic. The governor and his allies are confronted with a simple choice: stick to ideological principles and oppose Medicaid expansion out of partisan spite or listen to state hospitals and take simple steps to prevent medical facilities from closing their doors.
 
So far, they're not choosing wisely.