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Duane Goossen: Make the Medicaid ticker stop

Former Kansas budget director Duane Goossen.
Former Kansas budget director Duane Goossen.

Kansas topped $1 billion in forfeited federal funds early in 2016. But the clock kept ticking. Now losses have surpassed $2 billion, and the clock still ticks. Our failure as a state to adopt expanded Medicaid eligibility continues to cost us dearly, financially and morally.

Stop reading for a moment, and pull up the Kansas Hospital Association website: www.kha-net.org. Immediately you will see an hourglass-shaped “ticker” giving a running account of funding foregone. Watch as the dollar loss mounts. Tick, tick, tick. More than $1,000 a minute. More than $1 million a day.

Starting in 2014, Kansas could have allowed 150,000 more Kansans to become eligible for Medicaid health services. The federal government would have paid the whole tab for the first three years and then 90 percent thereafter. By now, more than $2 billion would have flowed directly into the Kansas economy.

Kansas only needed to say “yes.” Yet year after year, Gov. Brownback and his legislative allies have made sure the answer was “no,” not for logical policy reasons, but because expansion was part of Obamacare.

At first, many Kansans were also skeptical. But their attitude toward the Medicaid portion of Obamacare shifted as a majority of states — including red states Arkansas, Kentucky, and Iowa -- moved to expand. By 2017, surveys showed a strong majority of Kansans favoring expansion. That sentiment played out legislatively last spring, when a bipartisan majority of Kansas lawmakers voted to accept the federal funds, but Brownback quickly put his veto pen to the measure, and an override attempt fell a few votes short in the Kansas House.

As Brownback issued his veto, he likely thought Medicaid expansion was about to die anyway along with Obamacare. President Trump and a Republican Congress had put Obamacare repeal on the front burner nationally. Yet “Repeal and Replace” and the starker “Repeal and Replace Later” ultimately failed, in large part because of the blow that would have been delivered to Medicaid.

Medicaid expansion had proved to be an effective (and popular) way to reduce the number of Americans without health insurance. The Congressional Budget Office estimated that 32 million Americans would lose health insurance as a result of repeal and replace legislation. Republican governors of expansion states opposed repeal. Kansas Sen. Jerry Moran played a key role in keeping the possibility of Medicaid expansion alive for Kansas, after constituents let him know how they felt.

So now Medicaid expansion appears here to stay, and our years of refusal seem more financially inept than ever. Kansans who could have had health care have been left without or shunted to emergency rooms, a moral stain on the Brownback administration and on Kansas.

In June, the Kansas Legislature took an important step toward fixing the Kansas budget by rescinding Brownback’s tax policies. Expanding Medicaid eligibility should be the next step toward freeing Kansas from the troubles of the Brownback years, and that vote should occur immediately when the Legislature reconvenes in January. Stop the ticker, lawmakers.

Duane Goossen is a former Kansas budget director.

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