Momentum for Medicaid expansion?

Medicaid expansion in Kansas still seems unlikely, given how much Gov. Sam Brownback and Koch-backed groups oppose it. But offensive comments by the Governor’s Office and a forum next week in Wichita could build momentum for reform.

Melika Willoughby, the governor’s deputy director of communications, wrote a newsletter earlier this month blasting Medicaid expansion as a liberal plot to usher in “government-run health care.” She also claimed that expanding Medicaid without first eliminating state waiting lists for services for the disabled (a worthy but unrelated goal) was “morally reprehensible.”

Among those offended by her comments and misinformation was Senate Vice President Jeff King, R-Independence. His hometown hospital closed this month, and one factor in that decision was the state’s failure to expand Medicaid.

“Maybe if her hospital were closing, maybe if her parents were wondering where to go for emergency care, maybe if she faced uncertainty in her health care future, she would view those looking for health care answers in a little less judgmental light,” King wrote.

King has been uncertain about Medicaid expansion, which would extend privately provided health care to about 150,000 low-income Kansans, most of whom are working. But he is open to exploring a conservative, Kansas-focused approach to expansion.

That’s what will happen Tuesday at the Kansas Health Foundation Conference Center in Wichita. More than 200 state legislators, business leaders and other stakeholders will hear leaders from Indiana talk about their state’s “consumer-driven” Medicaid expansion plan, which includes health savings accounts and requirements that participants contribute to the cost of their care.

King, Sen. Michael O’Donnell, R-Wichita, and Reps. Dan Hawkins, R-Wichita, and Jim Ward, D-Wichita, also plan to participate in a panel discussion. The forum is sponsored by hospitals in Wichita and across the state, as well as the Medical Society of Sedgwick County and various groups focused on the medically underserved.

Hospitals support Medicaid expansion in part because the Affordable Care Act reduced payments to hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid). The reductions – which are estimated to total about $1.3 billion statewide over 10 years – are causing job cuts and threatening to put other Kansas hospitals out of business.

Expansion also would boost the Kansas economy. A 2014 study estimated that expansion could return $2.2 billion of our federal taxes to Kansas between 2016 and 2020, which could result in more than 3,700 new jobs by 2020.

But Brownback has made clear that he isn’t interested in expanding Medicaid, no matter how many people it helps. Americans for Prosperity also has threatened to “hold accountable” any lawmaker who supports expansion.

Still, more lawmakers are starting to realize, as King wrote, that “saying ‘no’ to everything isn’t an option.”

For the editorial board, Phillip Brownlee

This story was originally published October 29, 2015 at 7:07 PM with the headline "Momentum for Medicaid expansion?."