Nina Owcharenko, Ed Haislmaier and Patrick Parkes: Medicaid expansion is wrong solution

It remains one of the more contentious questions surrounding implementation of the Affordable Care Act in Kansas: Should the state adopt the law’s expansion of Medicaid?

Doing so would transform the program – shifting it from one that principally covers poor children and the disabled to one that covers able-bodied, working-age adults with incomes up to 138 percent of the federal poverty level.

Though expanding Medicaid might benefit hospital bottom lines, it would further burden state taxpayers. The Kansas Policy Institute estimated that expanding Medicaid would cost the Sunflower State nearly $625 million over the first 10 years (2014 to 2023). Though Obamacare promises states extra federal funding to cover initial expansion costs, that’s something the debt-laden federal government can ill afford. Should Congress decide it must scale back that extra funding to the normal federal match rate applied to the existing Medicaid program, state taxpayers would be stuck with making up the difference.

Researchers from Harvard University, the Massachusetts Institute of Technology and the National Bureau of Economic Research also have found Medicaid coverage to be no more likely than noncoverage to improve key health measures such as blood pressure, cholesterol and glycated hemoglobin levels used to track blood sugar stability. Moreover, Medicaid coverage aligned with an 18 percent spike in emergency room visits to treat nonemergency conditions that could have been handled in other, less expensive settings.

There’s another problem. Workers enrolled under the expansion have a disincentive to work longer or take a better-paying job. After all, if they earn “too much” and exceed the program’s income, they’ll lose their “free” coverage.

Today that’s simply not an issue for the vast majority of current Kansas Medicaid beneficiaries – of whom 57 percent are children, another 20 percent are disabled and a further 10 percent are low-income retirees – because they are not expected to work. But it does become a big problem if the program is expanded to able-bodied, working-age adults.

Indeed, 78 percent of the potential new enrollees in Kansas have no dependent children, and 56 percent are between the ages of 19 and 34. That is a population in need of more and better jobs, not expanded welfare benefits that incentivize them to work less.

What Topeka needs from Washington, D.C., is not a bigger Medicaid program but relief from federal rules and regulations – especially those added by Obamacare.

This story was originally published November 2, 2015 at 6:01 PM with the headline "Nina Owcharenko, Ed Haislmaier and Patrick Parkes: Medicaid expansion is wrong solution."