Hospitals still plan to push for Medicaid expansion

Kansas hospitals and other medical associations say they plan to push for Medicaid expansion during the upcoming legislative session, despite national uncertainty about the future of the Affordable Care Act.

Kansas hospitals have been outspoken about the financial burden they have incurred from the state’s inaction on Medicaid expansion.

Via Christi Health, the largest hospital system in Kansas, said in September that it has lost $28 million in revenue over the past two years because the state has not expanded Medicaid.

And at least 1 in 3 rural Kansas hospitals are at risk of closure. Many experts say expansion could help lessen that risk by providing reimbursement for currently uncompensated care.

Cindy Samuelson, spokeswoman for the Kansas Hospital Association, said the association plans to introduce a bill for Medicaid expansion in the 2017 session.

“Until we know what will happen on the federal level, we think it’s important to keep moving forward,” she said.

The Alliance for a Healthy Kansas, a new nonprofit organization supported by more than 100 Kansas businesses and organizations, has led much of the push for expansion in the past several months.

After years of failed attempts to garner Statehouse support for expanding Kansas’ Medicaid program, called KanCare, the group hopes newly elected legislators may be more sympathetic.

Moderate Republicans and Democrats will replace 31 conservatives when the Legislature convenes in January. The shift includes candidates who publicly support expansion, some of whom ran with expansion as a key area of their platform.

“Just because there’s uncertainty at the federal level doesn’t take away from the fact that we have hundreds of thousands of Kansans that don’t have health insurance,” said David Jordan, executive director for the Alliance for a Healthy Kansas. “Expanding KanCare will help expand coverage, create jobs and protect our hospitals.”

Lt. Gov. Jeff Colyer said in an e-mail that the administration hopes to make health care more affordable in the state but did not specify how.

“It is clear following last week’s elections that voters provided a mandate to take our country in a different direction and we expect to see major changes in Obamacare,” the statement said, referring to a popular name for the Affordable Care Act. “We intend to work with the Legislature to create a Kansas solution that makes health care more affordable and available to Kansans.”

Block grants suggested

U.S. House Speaker Paul Ryan recently proposed moving to a block grant system for Medicaid payment to each state. If that goes into effect, Rep. Jim Ward, D-Wichita and a member of the KanCare Oversight Committee, said it would be financially advantageous for Kansas to expand Medicaid and increase enrollment numbers.

“The idea of block granting Medicaid really should be an emphasis to expand so Kansas will have a bigger piece of that pie,” Ward said, adding that expansion would provide an “economic boost to a state that desperately needs an economic boost.”

Without Medicaid expansion, nondisabled adults without kids in Kansas cannot qualify for Medicaid, even if they don’t have income. Kansas is one of 19 states that have not expanded Medicaid.

President-elect Donald Trump promised repeatedly on the campaign trail that he would repeal the Affordable Care Act. On Friday, Trump said he is open to keeping key parts of the law.

Even if Congress makes significant changes to the Affordable Care Act, the timing of those changes is uncertain.

Many health insurance regulators require insurance companies to submit 2018 plans by April or May, which would be only a few months into Trump’s presidency.

And once people purchase 2017 plans, it would be legally difficult for Trump to cancel them before the one-year contracts run out. People began purchasing plans for 2017 on Nov. 1.

Furthermore, Republican lawmakers will hold 51 seats in the U.S. Senate, and a full repeal requires 60 seats.

“There’s a huge difference between voting symbolically to repeal coverage and voting to take coverage away from 20 million people,” said Jordan, executive director of the Alliance for a Healthy Kansas. “In Kansas, Pat Roberts and Jerry Moran would probably have to think twice – their vote would mean 87,000 Kansans would lose coverage.”

This story was originally published November 14, 2016 at 7:27 PM with the headline "Hospitals still plan to push for Medicaid expansion."