MERRIAM, Kan. -- Nearly a half million people in Missouri and Kansas make too little money to get health insurance on the federal marketplace, and they make too much to qualify for Medicaid. Both state legislatures decline to expand Medicaid to include them last year. Hospitals hope this year will be different.
Sandra Milleson is uninsured, and knows she'll still be cared for in the emergency department of Shawnee Mission Medical Center.
"They have to see you regardless. You don't have to pay anything up front," said Milleson.
But the care isn't free. Milleson says she owes at least $8,000 even with the medical center giving her relief through its charity care program.
"It's hard to live with that over your head," said Milleson.
The med center's CEO says providing that care for the uninsured is getting harder. The federal government is reducing payments it gives to hospitals for it. That's because the health care law includes an expansion of Medicaid to include many of the currently uninsured. But Kansas didn't go along with the expansion.
"We have the cuts without the anticipated coverage of some of those people in the gap," said Ken Bacon, Shawnee Mission's CEO.
So far, expansion appears unlike this session with Governor Sam Brownback not recommending that lawmakers debate it.
A spokesperson for the governor, Sarah Belfry, said "Obamacare is fundamentally flawed and the disastrous rollout is just another indicator of the problems we will continue to see."
Hospitals point out that states don't have to pay anything for Medicaid expansion in the first three years. It's all covered by the federal government.
"You can opt out if it doesn't make sense down the road, so I think it's worthy of consideration," said Bacon.
He hopes lawmakers will discuss some sort of expansion.
In Missouri, Governor Jay Nixon is again proposing Medicaid expansion. It's expected to be an uphill battle in the legislature.