Medicaid expansion advocates setting sights on next year

Gov. Sam Brownback talking with Anna Lambertson of the Kansas Medicaid Access Coalition last month at the Statehouse. The coalition delivered a petition with more than 2,700 signatures urging expansion of the state Medicaid program, which currently has among the tightest restrictions in the nation.

Gov. Sam Brownback talking with Anna Lambertson of the Kansas Medicaid Access Coalition last month at the Statehouse. The coalition delivered a petition with more than 2,700 signatures urging expansion of the state Medicaid program, which currently has among the tightest restrictions in the nation. by Phil Cauthon

Advocates pushing Kansas officials to expand Medicaid acknowledge it is unlikely they will achieve their goal this year.

But they said they remain hopeful they can convince Gov. Sam Brownback and legislators next year to make more Kansans eligible for the program.

“If it’s not going to happen the first year, we’ll continue to build grassroots support. We’re not giving up,” said Anna Lambertson, director of the Kansas Health Consumer Coalition, one of the groups pushing for expansion.

Medicaid, known in Kansas as KanCare, currently provides medical and long-term living assistance services for about 380,000 poor, disabled and elderly Kansans. Expansion could increase enrollment in the program by as many as 240,000, according to various projections.

The federal Affordable Care Act initially required states to expand Medicaid eligibility. However, the U.S. Supreme Court decision that upheld the law made expansion optional for states.

Expansion would have a bigger impact in Kansas than in many other states. That’s because the state’s current eligibility criteria exclude all but the poorest adults. Only those with children and incomes less than 32 percent of the federal poverty level — about $6,000 a year for a family of four — can qualify. Implementing expansion would mean that adults in that same family of four could make more than $31,000 a year and qualify.

The Brownback administration has estimated that expanding eligibility for the $3.2 billion program would cost the state an additional $600 million over 10 years.

Door still open

Whenever asked about expansion, Brownback says things that suggest he’s more likely to say “no” than “yes” to it. But advocates said they remain encouraged by the fact he hasn’t rejected the idea.

“If he’s really looking at the options with an open mind — as he himself has said he’s doing — then I see him taking his time (to decide) as beneficial,” Lambertson said. “I’d rather that he take his time than just say ‘no’.”

Last week, Brownback again expressed doubts that the federal government could afford to keep its promise to cover all the costs of expansion for the first three years and no less than 90 percent thereafter. Despite his misgivings, he said, he continues to have “active conversations” with expansion advocates and legislators on the topic.

“It’s in the legislative process,” Brownback said. “Expansion would have to be addressed by the Legislature. They would have to budget it.”

Brownback’s requirement that legislators budget for it before he would sign off on it has advocates convinced a decision won’t be made this year.

Budget negotiations

Members of the House-Senate conference committee negotiating a final version of the fiscal 2014-15 budgets are scheduled to return to the bargaining table early next month when the Legislature returns to Topeka for what leaders hope will be a brief wrap-up session.

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Tagged: obamacare, medicaid, act, aca, brownback, hospitals, share, disproportionate, affordable, dsh, expansion, care, kansas

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