Gov. Sam Brownback and state GOP lawmakers should put their conservative principles into practice and develop a Kansas-based solution to federal Medicaid expansion. Doing so would help low-income Kansans, the state’s hospitals and the Kansas economy – and improve the GOP’s image and the governor’s legacy.
The Kansas Hospital Association has a concept paper that is a good place to start. It builds on Brownback’s KanCare reform of Medicaid and includes provisions often touted by conservatives, including a premium-support program for purchasing private insurance, options for high-deductible plans and health savings accounts, and incentives for healthy behaviors and participation in job searches and training.
KHA’s provisions also include opting out of expansion if the federal funding rate drops below 90 percent. That addresses Brownback’s concern that the federal government might not honor its funding commitment.
KHA estimates that about 150,000 low-income Kansans, most of whom are working, would be helped by such a reform plan. This could also help businesses by boosting the health and financial well-being of their employees.
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A Kansas-based solution also would greatly help Kansas hospitals. The federal government reduced payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid). Via Christi Health is absorbing about $25 million a year in reimbursement cuts, and Wesley Medical Center and Galichia Heart Hospital are losing about $12 million together. The reductions – which are estimated to total about $1.3 billion statewide over 10 years – are causing job cuts and threaten to put some smaller Kansas hospitals out of business.
Returning more of our tax dollars to the state would also significantly boost the Kansas economy. A 2014 study estimated that a Kansas-based solution could increase federal funding by $2.2 billion between 2016 and 2020. That could result in more than 3,700 new jobs by 2020. A Kansas solution would also increase Kansas’ gross state product by more than $1.2 billion during that five-year period and increase total business activity by $2.2 billion, according to the study.
The state’s budget problems could be a major hurdle to a Kansas-based solution, because there would be additional costs. However, KHA estimates that a Kansas-based solution would pay for itself, factoring in the economic benefit of the job growth. Also, the hospitals might be willing to pay higher provider taxes to help cover additional costs.
Several other Republican-dominated states have come up with their own conservative alternatives to Medicaid expansion or are pursuing it. By blocking the federal expansion of Medicaid without pursuing alternatives, Brownback and the Legislature have appeared uncaring and obstinate. Developing their own Kansas-based solution would show otherwise and allow them to demonstrate how their conservative principles are best.
For the editorial board, Phillip Brownlee