The GOP-dominated Legislature voted overwhelmingly in 2007 to develop a “premium support” program in which low-income Kansans could purchase private health insurance through a “health care connector” – an idea that is nearly the same as the Obamacare insurance marketplace.
But after the state spent nearly a year developing the model, GOP lawmakers reversed course and decided to back an expansion of the State Children’s Health Insurance Program in Kansas – which is very similar to the Obamacare expansion of Medicaid.
“It’s a tried-and-true program,” state Sen. Susan Wagle, R-Wichita – elected as the new Senate president this week – said at the time about SCHIP.
And as lawmakers noted, the federal government would pick up a majority of the cost.
The back-and-forth continued last year when Gov. Sam Brownback returned a $31 million federal grant for Kansas to create an insurance exchange tailored to its needs – even though he had earlier noted it could benefit Kansas consumers.
Then last month Brownback announced that Kansas wouldn’t partner with the federal government to set up a health-insurance exchange. Instead, Kansans will have to use a federally created exchange.
Now Brownback faces another key choice.
The U.S. Supreme Court’s decision upholding the Affordable Care Act gave the state the right to opt out of the federal expansion – though doing so wouldn’t make any sense.
The expansion would enable at least 135,000 adults in Kansas to get health insurance; some estimates put the total at more than 200,000. And the federal government will cover the full cost of this expansion until 2016, and nearly all the cost afterward.
If Brownback doesn’t allow the expansion, not only will those Kansans lose out, so will the state’s hospitals and doctors. That’s because Obamacare reduces payments to help hospitals that serve low-income, uninsured patients (with the expectation that these patients will be covered by Medicaid). Without the expansion, hospitals and doctors won’t be reimbursed for some of the costs of this care – which likely would then be passed on in the rates they charge everyone else.
The expansion of Medicaid also would help reduce what the state now spends on health care for low-income Kansas who are disabled or mentally ill. In addition, the expansion would bring millions of dollars in new federal funds to the state, which would create several thousand new jobs.
Brownback hasn’t decided yet whether he will block the expansion of Medicaid. He said recently that the state was “still reviewing options.”
The GOP and Brownback have been all over the map on this issue. But if Brownback wants to help thousands of struggling Kansans, strengthen hospitals and boost the economy, there is only one option: Allow the Medicaid expansion.