The contrast is striking – and frustrating.
While Oklahoma is now working on a plan to expand Medicaid, Kansas refused to even hold a hearing on the issue this legislative session.
While Oklahoma wants to provide health insurance to about 175,000 of its citizens, Gov. Sam Brownback just cut funding to Medicaid – which could make life even harder for low-income Kansans.
Brownback announced Wednesday a 4 percent reduction in Medicaid reimbursement rates to doctors, dentists, nursing homes and hospitals (though not some rural hospitals). It’s part of his attempt to cover the state’s budget shortfall.
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Brownback administration officials have framed the cut as affecting only providers, and not a reduction in services. But others warn that reduced payments could cause more physicians and dentists to stop seeing Medicaid patients.
“You’re going to have some Medicaid recipients that won’t be able to find a provider,” said Rep. Jerry Henry, D-Atchison.
Meanwhile, Oklahoma is facing an even bigger budget shortfall than Kansas. But instead of cutting payments to providers, Oklahoma Gov. Mary Fallin wants to expand Medicaid.
The Oklahoma plan is modeled on an expansion approved in Indiana (as is a Kansas proposal developed by the Kansas Hospital Association). Participants would pay nominal premiums and co-payments, and the state would cover its cost of expansion with a $1.50-per-pack tax on cigarettes.
What is most striking about Oklahoma’s plan is that it is backed by Fallin, who had been a fierce opponent of Medicaid expansion. The main reason for her change of heart is financial.
Without Medicaid expansion, Oklahoma could be facing provider cuts of up to 25 percent. That could cause a collapse of the state’s health care system, particularly in low-income areas.
But expansion would bring hundreds of millions of dollars in federal funding to Oklahoma each year, which would help stabilize hospitals and boost the economy.
By not expanding Medicaid, Kansas has forfeited nearly $1.2 billion in federal funding since Jan. 1, 2014. That has hurt hospitals and the state’s economy – not to mention the estimated 150,000 Kansans who could have received health insurance.
The Oklahoma plan might not happen. It is still in the development stage, and the Koch-backed group Americans for Prosperity is determined to stop it.
But at least Oklahoma’s leaders are recognizing that Medicaid expansion can be both good for its citizens and the state’s budget. Brownback and the Legislature won’t even discuss it.