Sunday, November 30, 2014

Say "Yes" to Medicaid Expansion

By Duane Goossen

Click on this link. Spend a few moments watching the ticker there.

If you clicked, you saw dollars, fleeting before your eyes. Those dollars are fleeting away from Kansas because our political leaders have so far said “no” to expanding eligibility for Medicaid. Their decision has negative economic and negative moral implications.

Medicaid is a health program for low-income Americans. In Kansas, about 400,000 citizens, mostly children, receive health services through Medicaid. The federal government pays about 57 percent of the program's cost and Kansas pays 43 percent. However, if Kansas were to expand eligibility for Medicaid to more adults, the federal government will pay all of the costs for those newly eligible, until January 2017. After that, the cost split gradually goes to 90 percent federal, 10 percent state.

This new opportunity to cover more people began last January 1, and as that ticker shows, in less than a year, Kansas has already foregone more than $300 million and counting. More than half of states — 27 — so far have expanded Medicaid eligibility. Two more are actively considering doing so. Kansas is among the minority who have declined these federal funds to insure our most vulnerable citizens, but we still have the opportunity to change course.

Despite what many may think, it’s currently very difficult for an adult to receive Medicaid services in Kansas. Most childless adults do not qualify, regardless of income. Adults with children must have an annual income (family of four) below $9,063 to qualify.

Expanding eligibility would potentially allow 150,000 adults to gain access to health care, many of whom do not have any health insurance now. Uninsured Kansans often show up at hospital emergency rooms when they need care. The hospital provides the care, but in most cases receives no payment.

Why would Kansas turn away $400 million a year that the federal government would willingly spend here? Why would Kansas pass on the opportunity to have thousands of people gain health insurance coverage?

I cannot think of a good reason.

Consider a comparative example: Kansas political leaders from both parties have worked exceptionally hard to land the National Bio and Agro-defense Facility (NBAF) in Kansas. The project has the potential to bring in some hundreds of millions of federal construction dollars along with several hundred future jobs. Kansas has already issued $45 million in bonds and committed more than $100 million to attract the federal project. Great — but why not a similar effort to pull in an even greater amount of federal dollars and to give health insurance and peace of mind to fellow Kansans?

The Kansas budget is in trouble — now. The revenue stream has fallen so low that it no longer supports even a lean set of expenses. Expanding Medicaid eligibility would not add to the short-term problems. However, tragically, our self-imposed budget crisis has put our lawmakers in such a defensive posture that it’s a hard sell to agree to a future 10 percent match in order to attract $400 million now and each year going forward.

Break out of this crippling mindset, Kansas. Don't miss the opportunity to benefit our economy, Kansas hospitals, and uninsured Kansas citizens. Say "yes" to Medicaid expansion.

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