Expand KanCare

During a legislative session notable so far for scarce revenues and options, state lawmakers and the governor have a prime opportunity to bring dollars and jobs into the state while dramatically helping thousands of Kansans improve their health, well-being and quality of life:

They can expand KanCare, the state’s privatized Medicaid program.

Kansas need not do it Washington’s way. Kansans can tailor the KanCare expansion to best serve the state’s uninsured, health providers and communities. Proponents have listened to and learned from the opposition expressed by Republican lawmakers, taking pains to figure out how a KanCare expansion can work for Kansas as it brings an estimated 3,700 new jobs and $2.2 billion in federal funding to the state by 2020.

As of last week there are three bills filed for consideration – if only key leaders such as Senate President Susan Wagle, R-Wichita, and House Health and Human Services Committee Chairman Dan Hawkins, R-Wichita, will open the legislative process to it.

One by Rep. Jim Ward, D-Wichita, would expand eligibility outright as called for under the Affordable Care Act.

Another introduced last week by the House Vision 2020 Committee resembles the tailored, privatized approach taken in other GOP-led states. Responding to Republican concerns, expanded eligibility could be tied to work requirements. Hospitals and other providers would be charged fees to cover the state’s part of the expansion cost – an idea they’ve favored because of what expansion would mean to their bottom lines.

“This is as Kansas as the committee can make it,” Committee Chairman Tom Sloan, R-Lawrence, told the Kansas Health Institute News Service.

The third bill, offered at the request of Rep. Don Hill, R-Emporia, reportedly is the product of negotiations among the Kansas Hospital Association, the Brownback administration and legislators. It would leave the specifics to the Legislature, while removing a statutory roadblock to expansion passed in 2013.

Meanwhile, the reasons to proceed just get stronger, with ACA changes translating into about $25 million a year in reimbursement cuts for Via Christi Health and about $12 million a year less for Wesley Medical Center and Galichia Heart Hospital together. Some rural hospitals could shut down.

In every case – countering another GOP worry – the state could roll back the expansion if the federal government reneged on its commitment to cover 100 percent of the cost through 2016 and no less than 90 percent by 2020. Most important, as it increased the income eligibility to up to $16,105 for an individual and $32,913 for a family of four, expansion could bring 150,000 or more low-income Kansans off the uninsured rolls and into KanCare.

In its potential to aid people, boost employment and assist a vital economic sector under stress, KanCare expansion is unlike any other option available to the 2015 Legislature. Something that would be so transformative for the state merits a full debate at the Statehouse.

Kansas hospitals are counting on Gov. Sam Brownback to lead the way.

For the editorial board, Rhonda Holman

This story was originally published February 14, 2015 at 6:06 PM with the headline "Expand KanCare."