Eagle editorial: Costly not to expand Medicaid

07/26/2013 12:00 AM

08/08/2014 10:18 AM

Gov. Sam Brownback hasn’t expanded Medicaid eligibility because he says he is concerned about the cost. But two new reports by the Kaiser Commission on Medicaid and the Uninsured show how costly it is not to expand – especially for Kansans who need health insurance.

One report estimates that expanding Medicaid under the Affordable Care Act would reduce the number of uninsured Kansans by almost half, or 47.6 percent. That’s about 144,000 additional Kansans who could be receiving health insurance.

The report also notes that if Kansas doesn’t expand, it will lose out on about $5.3 billion in additional Medicaid funding over the next decade, which could significantly boost the state’s economy. At the same time, hospitals in Kansas will receive about $2.3 billion less in state and federal Medicaid payments, because ACA reduces payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid).

The other Kaiser report notes that about 58,000 uninsured Kansans will fall into a “coverage gap” starting Jan. 1. These are people, the Kansas Health Institute News Service reported, who are too poor to qualify for tax credits to buy private insurance but not poor enough to qualify for the state’s current Medicaid program.

So far, 23 states have approved the Medicaid expansion, while 21, including Kansas, are not expanding and six states are still debating the issue. Kaiser notes the states that haven’t expanded Medicaid would benefit the most, because they have a higher percentage of uninsured citizens who would be covered by Medicaid.

One reason the expansion would have a bigger benefit for Kansas than many other states is because Kansas has among the stingiest Medicaid eligibility criteria in the nation. Currently, only adults who have children and earn less than 32 percent of the federal poverty level ($5,900 for a family of four) are eligible.

Expanding Medicaid would also save the state money by moving some adults the state now cares for, such as those with mental illnesses, onto Medicaid and by reducing other costs. A study earlier this year by the Kansas Hospital Association calculated a net savings of $82 million from 2014 to 2020.

Several GOP governors have recognized the clear benefits of expanding Medicaid. One is Arizona Gov. Jan Brewer, who has been a fierce critic of Obamacare. Her explanation of why she backed expansion is something that Brownback and state lawmakers should ponder and heed.

“It’s pro-life, it’s saving lives, it is creating jobs, it is saving hospitals,” Brewer said. “I don’t know how you can get any more conservative than that.”

For the editorial board, Phillip Brownlee

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