Medicaid concerns

I am a medical student at the University of Kansas Medical Center, hoping to one day return to work as a family doctor in a small Kansas community such as my hometown of Russell. Knowing this is a career choice that will bring unique challenges, I am encouraged by the amount of support both my school and our state offers to students like me who recognize the enormous need for primary care in rural Kansas.

However, I am gravely concerned about your unwillingness to accept Medicaid expansion money offered through the Affordable Care Act. Not only would this decision put our state's rural hospitals at risk of going bankrupt, it would also discourage medical students like me from returning home.

Today, when an uninsured patient needs emergency medical care, he is treated -- by law -- regardless of his ability to pay. Fortunately, some of that cost is offset by reimbursements from the federal government. But now that each state has the opportunity to insure more of its citizens through Medicaid expansion, these reimbursements are scheduled to disappear. Because a majority of these funds currently go to rural hospitals, they will be hit the hardest.

If Kansas refuses to accept the money to expand Medicaid, uninsured adults will still need expensive emergency care and our hospitals will still be required to treat them. But now they will be stuck with the entire bill. This means either the price of medical services will skyrocket, or -- and more likely -- rural hospitals will be unable to make up for their losses and will be forced to close their doors.

I am up for many challenges in my career as a rural family doctor, but working in a community where the nearest hospital is more than three hours away is not one of them.

I understand Gov. Sam Brownback has some concerns about the state's eventual financial responsibilities with the Medicaid expansion, but I hope he will recognize the much greater cost to our rural communities and its hospitals should the state refuse to do so.

Jenny Maciaszek

Lawrence