Kansas lawmakers appear poised to pass a Medicaid expansion plan despite objections from Gov. Sam Brownback and uncertainty about the future of federal funding.
Senate President Susan Wagle, a Wichita Republican, doesn’t hesitate when asked if the expansion bill, which passed the House in late February, will clear the Senate later this month.
“I believe the bill passes on the Senate floor,” Wagle says, adding that she believes it will be approved by a wide margin.
“It will be close to veto proof … because the [Kansas] health care community has become very vocal,” she says.
Despite those predictions, Wagle says “the timing is wrong” for expansion because of uncertainty in Washington, D.C., as Congress debates how to repeal and replace the Affordable Care Act, the federal health reform law better known as Obamacare.
“It could sit there, because what I see the feds doing is winding that program down,” she says.
The American Health Care Act, the GOP federal replacement bill, would continue to provide most of the funding until Jan. 1, 2020, for the 31 states that have expanded their Medicaid programs. That gives Wagle and others pause. She worries that if federal Medicaid support drops below the 90 percent guaranteed in the ACA, Kansas would no longer be able to cover the low-income adults that expansion would insure.
“We would have to all of a sudden pull them off in 2020,” she says.
But health care providers and others advocating for Medicaid expansion see the deadline in a different light. They say it’s an opportunity to get in line for a program that Congress might not be able to shut down if all but a few states are relying on it.
“Our read of the bill is that it does not repeal Medicaid expansion,” says Tom Bell, president of the Kansas Hospital Association. “From our perspective, this provides states with some encouragement to actually expand their programs prior to that January 1 of 2020 date.”
David Jordan, executive director of the Alliance for a Healthy Kansas, a nonprofit advocacy group that supports expansion, expects that the number of Republican governors pushing to save Medicaid expansion will pressure Congress into preserving the program in some form.
“There is just as much urgency because we cannot afford to be left behind,” Jordan says. “Expanding KanCare puts us in line to be one of the states that has expanded before any changes to the ACA are made.”
KanCare is the name of the state’s privatized Medicaid program administered by three managed care organizations.
Currently, KanCare eligibility is limited to children, pregnant women, people with disabilities and seniors in need of long-term care who have exhausted their financial resources. Parents are eligible only if they earn less than a third of the federal poverty level, or about $9,200 annually for a four-person family.
Single adults without children currently are not eligible no matter their income.
Expansion would make all Kansans who earn up to 138 percent of FPL eligible, or $16,642 annually for an individual and $33,465 for a family of four.
It’s estimated that approximately 300,000 Kansas would qualify for coverage under expansion, though only about half that number initially would enroll.
The Senate Public Health and Welfare Committee has scheduled two days of hearings on the expansion bill, starting March 20. If the measure passes out of committee, as expected, the full Senate could vote on it the following week.
Jim McLean is managing director of KMUW's Kansas News Service, a collaboration of KMUW, Kansas Public Radio and KCUR covering health, education and politics in Kansas. Follow him on Twitter @jmcleanks.