By Scott Rothschild
Topeka — The leader of the Kansas Hospital Association said Friday that the state needs to take a serious look at expanding Medicaid under the federal Affordable Care Act.
“The bottom line for us is, frankly, we think it presents an opportunity to the state to look at some additional funding for a program that is already under-funded,” said Tom Bell, president of the Kansas Hospital Association. Gov. Sam Brownback, a conservative Republican, has said he is studying the issue. Several conservative Republican governors have rejected the option out of hand.
Bell said his association is working with Brownback on the issue.
“What we have tried to do, knowing the governor’s caution, which is reasonable, is to try to work with the administration and help answer the questions that the state needs to answer,” Bell said.
Currently, Medicaid provides health care coverage to about 380,000 Kansans, with the largest portion of them — about 230,000 — being children. The rest are mostly lower-income, pregnant women, people with disabilities and the elderly. The $2.8 billion program is funded with federal and state dollars.
Medicaid in Kansas doesn’t cover low-income adults who don’t have children. And a nondisabled adult with children is eligible only if his or her income is below 32 percent of the poverty level, which is approximately $5,000 per year. That is about the most difficult eligibility level in the country.
But starting in 2014, the ACA creates an eligibility level of 138 percent of the federal poverty level, which is $15,415 per year for an individual and $26,344 per year for a family of three.
Estimates indicate that Kansas’ Medicaid enrollment would increase by 135,000 people under the new rules. In addition, many more children probably would be helped, because when parents have access to insurance, it is more likely their children will, too.
If Kansas opts for the expansion, the federal government would pay for 100 percent of the additional cost for three years starting in 2014. Then the federal share would drop to 90 percent by 2020.
Bell said the expansion would help Kansas hospitals and thousands of Kansans who would probably receive better health care instead of waiting to be treated in an emergency room.
But he said he understood how some policymakers would be hesitant, given the federal government’s budget problems. On the other hand, Bell said, “It makes no sense for a state to jump out and say, ‘I’m not going to do this.’”
On Thursday, Missouri Gov. Jay Nixon, a Democrat, announced that he would push for the Medicaid expansion.
“If we take a pass on billions of health care dollars — dollars that come out of Missourians’ paychecks — that money will go to some other state. They’ll get the benefit, and we’ll get the bill,” Nixon said. “That’s not smart, and that’s not right.”
Republican legislative leaders, however, said Nixon’s proposal was probably dead on arrival.