Politics & Government

Kansas lawmakers hear pros, cons of expanding Medicaid

If Kansas opts to expand Medicaid under President Obama’s health-care law, 122,000 low-income adults probably would enroll and get taxpayer-backed health coverage.

That includes about 75,000 who are now uninsured, according to an analysis by the Kansas Health Institute.

And about more 118,000 kids probably would get Medicaid coverage, including 29,500 who are now uninsured.

An expansion probably would save the state some money since those who are insured tend to cost the state less in other assistance programs. But those newly enrolling Kansans may have put off health problems and have higher-than-usual expenses when they start seeing a doctor, the analysis said.

The additional coverage would come at a cost.

The state probably would shoulder about $70 million in expenses in 2014. State costs would grow after the federal government reduces its funding, reaching a total of about $518 million over six years, the KHI estimated.

Other studies show a wide range of cost estimates. The Center on Budget and Policy Priorities projects costs of $260 million over six years, and the Kansas Policy Institute estimates it could cost more than $2 billion over six years.

Lawmakers heard the estimates as part of a hearing Thursday that sought to show the pros and cons of expanding Medicaid under the Affordable Care Act.

Gov. Sam Brownback hasn’t yet decided whether to expand Medicaid. He did not include funding for the expansion in the budget proposal he released Wednesday.

Lawmakers said the wide range in estimates is worrisome, and some questioned whether they could depend on the federal government to continue its share of funding long term.

Brownback has fought Obamacare along with fellow conservative Republicans. His administration is working with an actuary to estimate potential costs associated with a complex expansion.

So far, eight governors have decided to expand Medicaid, and five have opted out.

Robert Moser, secretary of the Kansas Department of Health and Environment, said the state has been focused primarily on rolling out its reformed Medicaid program, which puts about 400,000 Kansans into a privately managed care system.

Moser said the state will present results of its Medicaid expansion study sometime in February.

“This is going to cost the state of Kansas in the long run,” he told the House Health and Human Services Committee. “We want to make sure we’re making the right decision.”

To qualify for Medicaid in Kansas as an adult, a parent has to earn less than 32 percent of the federal poverty level – about $7,376 for a family of four. President Obama’s health care law increases income levels to 132 percent of the federal level – or about $30,426 for a family of four.

Roughly 315,000 more Kansas would qualify under the expansion, although it’s unlikely everyone would enroll. The Kansas Health Institute estimates 122,000 adults would sign up and be fully covered by federal funds for three years before those funds are reduced to 90 percent.

And the KHI thinks about 29,400 Kansans who are already eligible would emerge and enroll as more people become aware of the option and residents face requirements to have insurance coverage under the new federal law.