Brownback compiling own estimate of Medicaid expansion cost

Mark Dugan, (right) chief of staff for Lt. Gov. Jeff Colyer, and KanCare ombudsman, James Bart.

Mark Dugan, (right) chief of staff for Lt. Gov. Jeff Colyer, and KanCare ombudsman, James Bart. by Phil Cauthon

The Brownback administration has not ruled out implementing the Medicaid expansion called for in the federal health reform law.

But a spokesman today told members of the Legislature’s Joint Committee on Health Policy Oversight that prior to making a decision administration officials want to develop their own estimate of how many Kansans are likely to sign up for the health care program and how much the expansion would cost the state.

“We’re continuing to study the issue,” said Mark Dugan, chief of staff for Lt. Gov. Jeff Colyer. “We would like to come to you with our own numbers.”

Currently, there are several competing estimates of how the expansion would affect Medicaid enrollment and the cost of the program. The latest, released earlier this month by the Kansas Health Institute indicated that approximately 240,000 additional low-income, disabled and elderly Kansans would enroll in a program that currently serves about 380,000. According to the KHI analysis, expanding Medicaid would cost the state an additional $519 million between its implementation in 2014 and 2020.

The KHI projections are higher than those in a 2010 report prepared for the now defunct Kansas Health Policy Authority and also higher than those in a state-by-state analysis done in 2010 by the Kaiser Family Foundation. However, they considerably less than those estimated in 2011 by the Kansas Policy Institute, a conservative think-tank based in Wichita, which has opposed the Affordable Care Act.

The KHI News Service is an editorially independent program of KHI.

Currently, Kansas’ Medicaid eligibility criteria for adults are among the most restrictive in the nation. Only those with children are eligible and only then if they earn less than 32 percent of the Federal Poverty Level — $5,900 a year for a family of four.

The ACA expansion would have a bigger impact in Kansas than many states. It would raise the eligibility threshold for all Kansans to 133 percent of FPL — $30,660 for a family of four.

Two of the four legislators who braved inclement weather to attend Thursday’s meeting of the 12-member committee made it clear that they favored the expansion.

Rep. Don Hill, a moderate Republican from Emporia, said that virtually all legislators regardless of party and ideology agree that the current health care system is broken and in need of reform to lower costs and reduce the number of people who are either uninsured and under-insured.

He said while the ACA is far from perfect, “it has some redeeming elements.” One of those, he said, is the Medicaid expansion because of its potential to extend coverage to many of the state’s 365,000 uninsured.

Citing the federal government’s promise to shoulder the cost of serving all those made eligible by the expansion for the first three years, Sen. David Haley, a Kansas City Democrat, asked, “Why can’t we cover more Kansans and why shouldn’t we?”

“I think we’re going to take a good look at it,” Dugan answered.

But, Dugan said, a factor that must be considered is whether or not the cash-strapped federal government can be counted on to keep its funding promise. After paying all of the costs of the expansion for three years, the federal government would gradually reduce its commitment until it reached 90 percent, where it would be maintained.

“He (Gov. Brownback) doesn’t have a high degree of confidence in the federal government maintaining that 90 percent commitment over the long term,” Dugan said.

Dugan said the federal government missed an opportunity to negotiate a compromise with Republican governors skeptical of the expansion when it rejected the idea of allowing states to increase eligibility to only 100 percent of FPL.

“That was an opportunity for middle ground that was lost,” he said.

Download the various cost estimates of expanding Medicaid in Kansas at

Tagged: obamacare, medicaid, act, aca, brownback, kansas, affordable, insurance, health, expansion, care, reform


Orwell 5 years, 4 months ago

We can expect the same sort of magic arithmetic that was used to support the Koch tax cut. They'll develop whatever "estimates" support the position they want to take for ideological reasons.

scarlett 5 years, 3 months ago

They ponder, count, and count again while people suffer and die. It is unconscionable.

Richard Heckler 5 years, 3 months ago

Neither women,men,children,republicans,democrats,green party,senior citizens,unemployed,employed can afford this party of Rt Wing Libertarian Neocon Fundamentalist Tea Party for Economic Terrorism.

This party of Rt Wing Libertarian Neocon Fundamentalist Tea Party for Economic Terrorism is not the economic giant of our time.

Their only goal is to launder more tax dollars to the medical insurance industry anyway possible. An industry that is unethical at best.

But one example.

Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.

At a committee hearing yesterday, three health-care specialists testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to mislead consumers about their benefits, and sell "junk" policies that do not cover needed care. Rockefeller said he was exploring "why consumers get such a raw deal from their insurance companies."

The star witness at the hearing was a former public relations executive for major health insurers whose testimony boiled down to this: Don't trust the insurers.

"The industry and its backers are using fear tactics, as they did in 1994, to tar a transparent and accountable -- publicly accountable -- health-care option," said Wendell Potter, who until early last year was vice president for corporate communications at the big insurer Cigna.

Insurers make paperwork confusing because "they realize that people will just simply give up and not pursue it" if they think they have been shortchanged, Potter said.

More on this story:

Richard Heckler 5 years, 3 months ago

There has never been a political solution to the astronomical rising costs of medical insurance.

Special Interest Campaign Expenses to several hundred congress people is damned expensive

8 lobbyists per elected official is damned expensive

Political convention expenses are damned expensive

$73 million $$$$ retirement bonus packages is damned expensive

Advertising is damned expensive

2 000 CEO's are damned expensive

Share holders are damned expensive and demand money

Money laundering $1.4 million $$$$ a day through the Chamber of commerce to defeat practical Medicare Single Payer Insurance is absurd

Keeping insurance employees on congressional staff is damned expensive

Insuring government people at 1.4 trillion tax $$$$ annually is enough to cover all people in America under Medicare Single Payer Insurance

The medical insurance industry is damned expensive all on it's own mismanagement and bloated bureaucracy!

Not one of the above items has anything to do with actually providing health care because the medical insurance industry does not provide health care.

Richard Heckler 5 years, 3 months ago

Other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 51 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $400 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste. Physicians for a National Health Program

Or medicare single payer such that the above is described could simply be offered as one of our choices. Then the consumers could decide. We need to remove politicians from the discussion of health care for they are so misinformed. Or on the take.

TongiJayhawk 5 years, 3 months ago

There are good and bad points on both sides of this issue. It's a very complicated issue and I'm not picking sides, but I do find one part of your piece quite funny!

"A single-payer system would be financed by eliminating private insurers and recapturing their administrative waste."

Your replacing private administrative cost with government administrative cost and are planning on saving money? Now that's funny!!

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