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Missouri Medicaid-Bond

FILE - In this Sept. 27, 2011 file photo former Missouri U.S. Sen. Kit Bond, right, is greeted before speaking in Jefferson City, Mo. The Missouri Chamber of Commerce and Industry said Thursday, Jan. 23, 2014 that Bond's lobbying firm has been hired to lobby his fellow Republicans in the Legislature to support Medicaid expansion. (AP Photo/Jefferson City News Tribune, Kelley McCall, File)

Missouri is facing a health care crisis, one that is threatening both urban and rural communities. Hardworking families cannot afford health insurance, hospitals are struggling to keep their doors open, and services for low-income Missourians are being cut or eliminated. Meanwhile, bureaucrats in Washington, D.C., and our legislators in Jefferson City are blocking common-sense solutions to protect our vital health care safety net.

In our rural communities, access to health care can be a matter of life or death. If the hospital closes in a farm town, there is not another ER for many miles, costing precious minutes in life-threatening emergencies like a heart attack, car crash or tractor accident. Thanks to new financial burdens, like expensive federal mandates for technology upgrades and Obamacare-mandated cuts in funds hospitals receive for uncompensated care — the care hospitals are required by law to provide regardless of folks’ ability to pay — hospital closures are already happening. Last year, the Missouri Rehabilitation Center and VA Clinic in Mount Vernon and the Sac-Osage Hospital in Osceola both closed, costing hundreds of good jobs and threatening access to health care.

Urban communities are facing similar challenges. With more uninsured patients than suburban hospitals serve, paltry reimbursement rates and rising costs, inner-city hospitals have been boarding up in droves. The Obamacare-mandated cuts for both uninsured and Medicare patients will only worsen this crisis in Missouri’s cities.

This dire situation has forced hospitals to get creative. Rather than closing, some hospitals in both rural and urban communities are joining existing hospital systems or creating new ones. In Missouri, one of our most respected hospital systems was formed this way — in 1993, Barnes-Jewish Inc., a St. Louis urban hospital, merged with Christian Health Services, a group of suburban community hospitals. A year later, Missouri Baptist Medical Center and St. Louis Children’s Hospital joined the system, now called BJC HealthCare. It’s one of the best health care systems in the country.

These new partnerships between hospitals improve their efficiency and provide the funds needed for new staff training and upgrades to existing infrastructure. But most importantly, these hospitals are keeping their doors open and preserving access to care in these communities.

Despite helping to create the problem for hospitals with expensive new mandates and cuts to reimbursements, the federal government is now making it difficult for these hospitals to deploy this private-sector solution. Currently, the Federal Trade Commission is moving painfully slow to evaluate any proposed merger or system expansion. Reviewing applications through the narrow lens of a century-old anti-trust law, the FTC is taking months or even years of bureaucratic analysis to approve these hospital partnerships — often too late for a community on the brink of losing its only hospital and largest employer.

Inaction by legislators in Jefferson City is also putting our health care safety net in Missouri at risk. State Sen. Ryan Silvey, R-Kansas City, has proposed a solution to reform our state’s Medicaid program that would increase access to care for hardworking Missourians, protect our health care safety net in rural and urban communities, and safeguard the state’s budget.

Unfortunately, anger over Obamacare has confused the issue, and right now, legislators are refusing to consider this common-sense solution and standing by while hospitals like those in Osceola close their doors.

Missouri families and communities cannot afford to let politics in Jefferson City or bureaucrats in Washington, D.C., prevent solutions to our health care crisis from being implemented. It is time for our policymakers to act.

Christopher S. “Kit” Bond is a former U.S. senator and Missouri governor. His firm is lobbying for Medicaid expansion.