Opinion Columns & Blogs

Barbara Shelly: Kansas ailing in Medicaid study


Lawmakers in Kansas who have been blocking Medicaid expansion don’t realize it, but they’ve been participating in a medical study.

Since 2013, researchers at Quest Diagnostics, the nation’s largest medical testing provider, have tracked patients newly identified with diabetes. Overall, they charted an increase of 1.6 percent in 2014 over 2013.

But in states that had expanded Medicaid eligibility to the limits called for in the Affordable Care Act, a dramatic number emerged. New diagnoses of diabetes within the Medicaid population increased by 23 percent.

In states such as Kansas that refuse to make access to health care affordable to the working poor, the increase in newly diagnosed diabetes patients was less than 1 percent.

This means in the Medicaid expansion states, people are visiting doctors, getting tests and learning much earlier that they have a chronic disease that can cause catastrophic complications, especially if untreated. Access to affordable health care will keep them healthier and spare states from ultimately assuming the tremendous costs of severe disability. Persons critically ill with diabetes often end up in nursing homes, for instance.

Authors of the study, published in the Diabetes Care journal of the American Diabetes Association, wrote that similar findings were likely in diagnoses of other chronic diseases such of hypertension and kidney disease. Diagnoses of HIV, the virus that causes AIDS, have been found to be higher in Medicaid expansion states.

When drafting the Affordable Care Act, members of Congress had intended for all states to raise Medicaid eligibility limits to 138 percent of the federal poverty level. It was a crucial building block for getting health insurance to as many Americans as possible. In Kansas, only parents who make less than 26 percent of the poverty level are currently eligible.

But a later Supreme Court ruling made Medicaid expansion optional for states. Unfortunately, 22 of them are still holding out.

Recalcitrant lawmakers and governors cite concerns about Medicaid’s cost and effectiveness as reasons not to expand Medicaid.

But the federal government will pay 100 percent of the expansion through 2016, and never less than 90 percent. States save money as Medicaid begins to cover certain populations, such as indigent mentally ill individuals, who have until now been a state responsibility. States also receive an economic boost from the federal dollars used to expand health care networks.

Studies are finding that states such as Kentucky and Arkansas, which expanded Medicaid early, are saving money.

Lawmakers who carp that Medicaid is ineffective and prone to fraud should take advantage of the federal money that comes with expansion to make their systems more efficient. And the results of the Diabetes Association study suggest that state Medicaid programs are having success in getting people tested and diagnosing expensive chronic diseases.

Rarely does a week go by without another study indicating the fiscal and medical benefits of Medicaid expansion. States that have it increasingly appear healthier and smarter. It’s time for Kansas to move out of the comparison group.

Barbara Shelly is a columnist with the Kansas City Star.