Heed will of Legislature, public on Medicaid expansion

Gov. Brownback should respect the will of the Legislature – and the public – and allow Medicaid expansion.
Gov. Brownback should respect the will of the Legislature – and the public – and allow Medicaid expansion.

Gov. Sam Brownback signed a bill into law in 2014 that required an act of the Legislature to expand Medicaid in Kansas. Well, both the Kansas House and Senate have now acted – approving an expansion bill with large bipartisan majorities.

Brownback should respect the will of the Legislature – and the overwhelming public support for Medicaid expansion – and allow the bill to become law, either with his signature or without.

The Senate gave final approval of the bill Tuesday by a vote of 25-14, with a majority of Republicans joining Democrats to support expansion. The House earlier passed the bill 81-44.

The bill would allow expansion to begin next January. Not only would this enable about 150,000 low-income Kansans, most of whom are working, to qualify for Medicaid, it could help businesses by boosting the health and financial well-being of their employees.

Expansion also is critical to Kansas hospitals. Reductions in federal payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid) are squeezing the budgets of hospitals. This is especially a problem at struggling rural hospitals.

Returning more of our tax dollars to the state also would boost the Kansas economy. A 2014 study estimated expansion could increase federal funding by $2.2 billion between 2016 and 2020. That could result in more than 3,700 new jobs by 2020. Kansas has already missed out on nearly $1.8 billion in federal funding since Jan. 1, 2014.

In Sedgwick County, about 21,000 residents would gain insurance coverage, resulting in about $89 million in new annual health care spending and more than 550 new jobs, according to the Alliance for Health Kansas, a broad-based advocacy group supporting expansion.

It’s no wonder 82 percent of Kansans support Medicaid expansion, according to a recent survey commissioned by the American Cancer Society Cancer Action Network.

Even if Congress and President Trump end up passing health care reform, it is important for Kansas to approve Medicaid expansion while it can. That is because Republicans and Trump want to change Medicaid funding to block grants, which likely would be based on per-capita Medicaid populations. So the states that expand Medicaid would get much larger block grants – paid in part by the taxes from states that didn’t expand.

When Brownback signed the 2014 bill into law, former Republican Rep. John Rubin, who championed the bill, noted that it didn’t take a position on Medicaid expansion. Rather, he explained, the law says it “should be up to the people’s elected representatives to make that decision.”

The people’s representatives have spoken. Now Brownback needs to listen.