Gov. Sam Brownback is in the process of determining whether to expand Medicaid in Kansas to cover citizens with incomes up to 138 percent of the federal poverty line as set forth in the Affordable Care Act. I strongly urge the governor to take this step, as it will provide coverage for hardworking Kansas who are struggling to make ends meet.
Medicaid expansion under the ACA will both expand access to health care for people who desperately need it, and save the state money. This issue is particularly important to Kansans ages 50 and older, who are not yet eligible for Medicare. During this historic economic recession, many of these individuals have lost their jobs and their employer-sponsored insurance coverage.
Moreover, while people with incomes from 100 to 400 percent of the federal poverty rate will be eligible for the federal tax subsidy to partially offset the cost of their insurance beginning in 2014, without exercising the Medicaid expansion option, Kansas will effectively create a coverage gap in the state for those with incomes less than 100 percent of poverty.
Expanding Medicaid will not only help provide coverage for hardworking Kansans who have fallen on hard times. It also will give people without insurance access to preventive care that can save lives, reduce the need for expensive emergency room care, and ease emergency room overcrowding that threatens all of us.
According to research from AARP’s Public Policy Institute, expanding Medicaid would provide health coverage for an estimated 20,219 uninsured Kansas residents ages 50 to 64, based on the number of Kansas residents ages 50 to 64 who were living at or below 138 percent of poverty in 2010. Older adults are particularly vulnerable to deterioration in function and health status if they do not have health coverage.
There has been some concern that by increasing the number of individuals who receive Medicaid, the cost to the state will increase dramatically. Actually, expansion can benefit Kansas beginning in 2014, because the federal government will provide 100 percent matching rate. If we do not expand Medicaid, however, Kansas will have to pay the matching rate of 56.5 percent for people newly eligible to receive services.
It is hard to predict how many newly eligible people will apply for services. According to a recent Urban Institute report, about 169,000 newly eligible uninsured Kansans of all ages would meet the expansion eligibility requirements in 2014.
Whether or not the state accepts the expansion option, Medicaid enrollment will increase as some who are currently eligible under existing state Medicaid standards will now enroll as a result of outreach and education about health care coverage programs, and simpler application and eligibility determination processes as provided for in the ACA.
Medicaid expansion makes fiscal and practical sense. By expanding coverage to more Kansans who need help, the state will benefit from the increased federal match while also ensuring there are no reductions or cuts to valuable programs.
As the governor considers options and determines whether to fully expand Medicaid, I urge him to consider what will be in the best interest of all Kansans.