Medicaid expansion harms state

A guiding principle of the medical profession is “do no harm.” But Kansas state legislators are contemplating a policy that would harm our state and many of its most vulnerable patients.

The idea is to expand the state’s Medicaid program by adding nearly 100,000 able-bodied adults to the Medicaid rolls.

Our leaders must resist the siren call to expand Medicaid. Not only would expansion cost Kansas taxpayers hundreds of millions of dollars, it would eventually lead to cuts in other key services, including education.

We need only to look at the states that expanded their Medicaid programs to see the consequences. Nearly all experienced costs far higher than expected.

When Illinois expanded its Medicaid program in 2013, spending quickly grew out of control. The program’s cost went over budget by $800 million in the first year alone.

Likewise, Medicaid expansion in Ohio ran nearly $1.5 billion over budget in its first 18 months.

Arkansas is one state that attempted a so-called limited-government approach to expansion. Under this plan, the state uses Medicaid dollars to enroll newly eligible adults in private health insurance plans through the Obamacare exchange.

While this was billed as a way to control costs, the program was still $137 million over budget after the first six months. In order to stem the bleeding, Arkansas will now charge premiums to some of the new Medicaid recipients and require that others look for work.

The results in these and other states should serve as a warning to Kansas lawmakers: Medicaid expansion is no free lunch.

Under Obamacare, the state would be responsible for 10 percent of the cost of the expansion by 2020 (the federal government would cover the remaining 90 percent). The Kansas Health Institute estimates that state costs would reach $1.1 billion over 10 years.

We should not expand a failed federal health care program just as the new administration begins the process of repealing and replacing Obamacare. We cannot rely on Washington, D.C., to fund a massive Medicaid expansion that was a key component of the health law. Kansas taxpayers already face enormous costs under Obamacare, and they could be left holding the whole bill for expanding Medicaid.

The existing Medicaid system in Kansas costs $1 billion per year. Enlarging this already-costly program would put the squeeze on other budget priorities, such as infrastructure and K-12 education. At a time when state lawmakers already struggle to balance the budget, we can scarcely afford a surge in new government spending.

Expanding Medicaid would also hurt many of the patients it’s supposed to help. People on Medicaid already struggle to find a doctor that will accept their insurance. Adding tens of thousands of able-bodied adults to the program will not likely increase the number of providers accepting Medicaid, but it could crowd out the children, pregnant women, and disabled individuals whom the program currently serves.

Kansas lawmakers should instead implement a review of the current Medicaid program to ensure that the most vulnerable among us have access to the care they need.

This story was originally published January 12, 2017 at 5:01 AM with the headline "Medicaid expansion harms state."