A new proposal for expanding Medicaid is smart and Kansas-focused. It also addresses objections to expansion raised by Gov. Sam Brownback and some lawmakers.
But GOP leaders in Topeka are still resistant, blocking an attempt Wednesday by Rep. Jim Ward, D-Wichita, to force a House vote on expansion.
Senate Bill 371 and House Bill 2633 are based on an expansion plan developed by the Kansas Hospital Association. It was modeled after Indiana’s law and contains several requirements and reforms championed by free-market conservatives.
For example, expanded Medicaid would be available only to U.S. citizens who have lived in Kansas for at least a year. The plan requires referrals to the state’s workforce training and job search programs for nondisabled adults who are working fewer than 20 hours a week. It also includes health savings accounts and co-payments to promote personal responsibility.
The plan calls for the termination of expansion if the federal funding falls below its required match. This addresses Brownback’s initial objection that the federal government can’t be trusted to honor its funding promise.
Brownback and some lawmakers also have demanded that expansion not add to the state’s budget burden. This plan is projected to be budget-neutral, in part because federal funding would help pay for services that the state is now absorbing, such as some mental health care. A study released in December estimated that expansion could even be a net budget savings for Kansas.
Brownback also contends that the state needs to eliminate all waiting lists for separate, unrelated services to Kansans with disabilities before it expands Medicaid. But individuals with disabilities object to Brownback using them as political pawns, and endorsed expansion at a rally last month in Topeka.
While opponents are running out of objections, the case for allowing expansion remains strong:
▪ Expansion would enable about 150,000 Kansans, most of whom are working, to obtain health insurance. This could also help businesses by boosting the health and financial well-being of their employees.
▪ Expansion would benefit hospitals. Reductions in federal payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid) are squeezing the budgets of hospitals and contributed to the closing of the hospital in Independence last year.
▪ Expansion would boost the Kansas economy. A 2014 study estimated that expansion could increase federal funding by $2.2 billion between 2016 and 2020. That could result in more than 3,700 new jobs by 2020. Kansas has already missed out on nearly $1 billion in federal funding since Jan. 1, 2014.
The expansion plan is a smart solution to help Kansans, hospitals and the economy.