Medicaid debate creeps closer to Kansas legislative session

The Medicaid expansion debate continues.

Kansas lawmakers, health care officials and business leaders gathered Tuesday in Overland Park for a forum hosted by the Kansas Hospital Association in hopes of widening support for KanCare expansion before the 2016 legislative session starts Monday.

KanCare is the Kansas Medicaid program, which provides insurance for people with low incomes or disabilities.

The event mirrored a November forum in Wichita hosted by 14 health care organizations with the same goal: Convince Kansas Republicans to expand Medicaid.

Much of the state’s resistance to expansion stems from its ties to the Affordable Care Act.

The act was passed with the expectation that Medicaid would be expanded nationwide. The Supreme Court later allowed each state to expand on its own. Thirty states and the District of Columbia have expanded Medicaid; Kansas has not.

Private-sector support for Kansas expansion has grown in the past six months. Hospitals around the state attributed revenue declines, in large part, to donated care for uninsured patients.

The Wichita Metro Chamber of Commerce added Medicaid expansion to its list of policy priorities for 2016 because of its potential to lower business costs.

Legislators at Tuesday’s event remained open to discussion of the issue this session. But some say the power to “move the needle on the issue” lies higher up.

“I don’t believe that any of us – even if we wanted to push it – that we could move that needle unless we had a leadership position that could move this forward,” said Rep. Mark Hutton, R-Wichita, mostly in reference to Gov. Sam Brownback, an opponent of expansion.

Block to expansion

The nearly three-hour event included presentations about expansion, panel discussions with business owners and lawmakers, and a question-and-answer session.

Dave Kerr, a Republican and former state Senate president from Hutchinson, led a presentation about projected savings from Medicaid expansion and the demographics of those who would be eligible for Medicaid through expansion. Most are Kansans who have a job.

Kerr, along with many other panelists at the forum, highlighted the tie to the health care act as a primary obstacle to expansion.

Support for expansion can be seen as being supportive of the Affordable Care Act.

He said he in no way supports the act that his tenure in state government has taught him not to dismiss the views of his opponents.

“Seldom are they 100 percent in error,” Kerr said.

The money

Kerr presented the impact of savings versus cost of Medicaid expansion on the Kansas state general fund.

The savings equaled $218 million for 2017, according to a study from Manatt Health Solutions. Kerr said even with a 50 percent margin of error, the state general fund still profits.

Even with the revenue estimates, some legislators remained dubious of the costs associated with expansion.

“(There’s) lots of holes in the projections, and we’ve had our shares of misprojections in the past four years,” said Sen. Jim Denning, R-Overland Park.

Doug Leonard, president of the Indiana Hospital Association, talked about how conservative Republican lawmakers there formed a plan with co-pays and out-of-pocket costs to create accountability for recipients.

He criticized Brownback’s moral claim against paying for the care of able-bodied adults.

“The fact that we would turn able-bodied people into a pejorative is wrong,” he said.

“There are so many people out there that are in a precarious situation, and it’s usually health care that causes them to tip into bankruptcy. It’s your neighbors, your businesses.”

This story was originally published January 5, 2016 at 8:09 PM.