Topeka ? Approximately 70,000 more Kansans could receive taxpayer-funded health coverage under reform proposals being worked on in Congress, according to a leading state health official.

But whether health reform would increase or decrease the cost to the state is still up in the air, said Andrew Allison, Kansas Health Policy Authority executive director.

“That’s very hard to pinpoint because there are so many variables at play,” Allison said.

The KHPA is tracking health care legislation in Congress to determine the impact any final bill would have on Medicaid and the State Children’s Health Insurance Program, or SCHIP.

In Kansas, Medicaid, which is funded through federal and state tax dollars, covers mostly children from low-income families, people with disabilities and senior citizens. SCHIP provides coverage for children from families earning too much to qualify for Medicaid but still not enough to purchase private insurance.

Under a bill being considered by the Senate Finance Committee, an expansion of the income limits for Medicaid would bring more than 100,000 new Kansans into the program. But more than 40,000 children and some pregnant women would be shifted from Medicaid and SCHIP into private coverage through a proposed reformed marketplace with new federal tax subsidies.

Allison said, “On net, our best guess at this point is that the Medicaid program would grow by about 70,000 under the original” proposal made by Senate Finance Chairman Max Baucus, D-Mont.

That would be an increase of 25 percent from current enrollment in Medicaid and SCHIP.

Despite the increase in enrollment, state costs could actually go down, Allison said.

That is because under the various proposals, the federal government would pick up almost the entire cost of new people coming onto Medicaid, and there are provisions to save through reduced prescription drug costs and redirecting funds used to pay for the uninsured.

“Simple implementation of the Senate’s original draft would probably reduce state spending in the long run, but there’s a lot of turf to cover between now and the year 2014, when most of the reforms would take effect,” Allison said. “The question of whether they save money or cost money may well come down to a series of choices the state itself will have to make between now and then.”

Some have also argued that requiring everyone to have health insurance would reduce catastrophic health costs and emergency room treatment.

Kansas Insurance Commissioner Sandy Praeger said at a recent KHPA board meeting, “We want people to get health care in the doctor’s office, not the emergency room.”