Kansas groups pushing for Medicaid expansion

Members of the Kansas Medicaid Access Coalition made their case for expansion recently at a Statehouse news conference.

Anna Lambertson, executive director of the Kansas Health Consumer Coalition, said expanding adult Medicaid eligibility would have a bigger impact in Kansas than many other states. That’s because the state's current requirements exclude all but the poorest adults. Only those with children who make less than 32 percent of the federal poverty level – less than $6,000 a year for a family of four – can qualify. Implementing expansion would mean that adults in that same family of four could make more than $31,000 a year and qualify.

Several legislators have said they oppose the expansion because of the anticipated cost. But Lambertson said that should not be the main issue for them because the Affordable Care Act would require the federal government to cover 100 percent of the cost of the newly covered for the first three years and 90 percent after that.

“The state will never pay more than 10 percent for this huge benefit,” she said.

The Brownback administration has estimated that expanding eligibility for the $3.2 billion program would cost the state an additional $600 million over 10 years.

A study done for the Kansas hospital association estimated that expansion would increase the amount of federal Medicaid funds flowing into the state between 2014 and 2020 by $3 billion and create 4,000 new healthcare jobs.

Currently, Medicaid, known in Kansas as KanCare, provides medical and long-term, living assistance services for about 370,000 poor, disabled and elderly Kansans. Expansion could increase enrollment in the program by as many as 240,000, according to various projections.

Polls show expansion support

A hospital association poll showed that 60 percent of Kansans surveyed favored expansion. Maren Turner, executive director of AARP Kansas, said a recent poll of Kansans over 45 commissioned by her group had similar results. She said more than 40 percent of the Republicans surveyed favored expansion.

“Medicaid is not a partisan issue,” Turner said. “It’s a critical issue no matter what your politics are. We hope the governor and the Legislature are listening.”

Several conservative Republican governors have recently announced that they plan to expand Medicaid in their states even despite their opposition to the federal health reform law.

Brownback has yet to make a decision but has repeatedly expressed concerns about the federal government’s ability to keep its funding promises.

Many Republican legislators share his concerns, including Rep. Scott Schwab of Olathe.

“It’s typical Washington, ‘if you do what we say then we’ll give you the money’ and then the money runs out and we’re stuck with a liability we can’t afford,” he said.

A resolution that would put the Legislature on record opposing expansion has been endorsed by a House committee and awaits a vote on the floor. Several legislators said that debate had not been scheduled because House leaders are uncertain they have the votes to pass the resolution, which would be non-binding but send a strong signal to the governor.

Lambertson and other coalition members said speculation about what the federal government may or may not do is not reason enough to reject expansion.

“The law states that the federal government will cover 100 percent of the costs for the first three years and 90 percent thereafter,” she said. “We’re going to advocate for the expansion and hold the federal government to that promise.”

The Arkansas option

A tentative agreement that Arkansas officials say they’ve struck with federal officials has been getting attention in recent days as a possible alternative to expanding Medicaid.

Gov. Mike Beebe, a Democrat, is proposing to use federal dollars to purchase private coverage for people who would have been made eligible for Medicaid under the expansion.

Gary Cohen of the U.S. Department of Health and Human Services, confirmed in a conference call Tuesday with reporters that the agency might permit other states to follow Arkansas’ lead, if and when details are worked out and the agreement is finalized.

“We’re exploring avenues in which that might be able to happen,” an online report in the Washington Post quoted Cohen as saying.

Sara Rosenbaum, a health law professor at George Washington University, said in the Post article that if Arkansas were allowed to proceed, several other conservative governors likely would be interested in doing the same.

“If Arkansas is allowed to do this, I expect it to spread like wildfire,” she said.

Florida legislators already are talking about scrapping Gov. Rick Scott’s expansion proposal and pursuing an agreement similar to the one that Arkansas has negotiated.

A spokesperson for Brownback didn’t immediately respond to questions about whether the Arkansas alternative was being considered by the administration.

Lambertson said the coalition hasn’t taken a formal position on an Arkansas-like approach in Kansas.

“When more details come out about the Arkansas model maybe we can look at that and see what it means,” she said. “But we like the solution we have on the table right now.”

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