Though Medicaid expansion could help rural hospitals make a little more money, it’s not enough to save them, according to House Majority Leader Dan Hawkins.

“Medicaid expansion is very much centered around the economic centers where people are,” said Hawkins, a Republican from Wichita. “You don’t see as many out in the rural areas.”

For the least affected rural counties, it wouldn’t even be enough revenue to hire one more employee.

“Washington County gets a whole $8000,” said Hawkins. “Sheridan County, clear out on the western edge of the state gets $6000, Ottawa County, $4000. Greeley County, $25,000 and it starts going up from there.”

The closure of the hospital in Independence in 2015 was cited at the time as being somewhat caused by the lack of expanding Medicaid.

“The CEO of Mercy Hospital at Independence came out after enough time and said, listen, that may have put a band-aid on it for three months, but it wouldn’t have kept us open,” said Hawkins. “The same thing’s happening with Fort Scott. Right now, they’re talking about Fort Scott, that if Medicaid expansion was here, Fort Scott wouldn’t have closed, well, smart people understand economics. If you’re losing $15 million a year, and you’re given a couple of million dollars in the form of Medicaid expansion, now you’re losing $13 million a year. Do you stay open?”

Hawkins is convinced that in order to make rural health care more accessible, the narrative needs to change and a focus needs to go back on doing primary care in other ways, so that overall health can stay strong while keeping costs reasonable.