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Archive for Saturday, November 24, 2012

Governor taking cautious approach to Medicaid expansion

November 24, 2012

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Topeka — Gov. Sam Brownback is taking a wait-and-see attitude about whether to opt-in to expansion of the Medicaid program under the federal Affordable Care Act.

“We’re talking with other states about what they are doing, still reviewing options,” Brownback said recently.

And like all things related to the ACA, sometimes called, “Obamacare,” politics is involved. A handful of states, all led by Republican governors and outspoken critics of the Affordable Care Act, have ruled out expansion of Medicaid. Those states, which include Texas, Oklahoma, Georgia, Mississippi and South Carolina, have among the highest rates of uninsured citizens in the country.

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. Estimates show that about 70 percent of Kansas children currently without health insurance actually are eligible for Medicaid but are not enrolled.

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.

Some health care experts have argued that states would be foolish to pass this up. It would provide coverage to people who are currently uninsured and help hospitals that are struggling to care for those people now.

But some governors, Democrats and Republicans, say they are wary that the federal government, as it grapples with budget problems, will put states on the hook for increased expenses.

Shannon Cotsoradis, president and CEO of Kansas Action for Children, disagrees. Kansans already are paying for the health care of the uninsured, she said, whether it’s in the form of higher hospital costs or premiums.

“The costs of the uninsured are just hidden now,” she said.

She said expanding Medicaid will provide cost-effective preventative care for thousands of Kansans. And, she argued, if Kansas doesn’t participate, the state’s taxpayers are leaving money on the table to help other states.

Cotsoradis said she believes some governors are waiting to see whether the federal government will provide any more flexibility in the program’s expansion before they commit.

Comments

KS 2 years, 2 months ago

Poor taxpayers if it is expanded. Where will it stop?

Trumbull 2 years, 2 months ago

When will rising premiums stop? What costs more.....taxes.....or rising premiums? Who should we trust more? The Government or the Insurance Biz?

verity 2 years, 2 months ago

Where will it stop? Hopefully with single payer.

Orwell 2 years, 2 months ago

“We’re talking with other states about what they are doing…"

Other states are laughing their backsides off at the Kansans who will pay the taxes that will support Medicaid, even when Kansans won't benefit because of partisan intransigence.

Thanks a pantload, Sam.

Kat Christian 2 years, 2 months ago

Look how low our State min wage per hour is...lowest in the country. Most states adopted Federal min wage, but not Kansas. Just don't think our State Government really cares for the people, it more like for the politicians, Corporations and their CEOs, and where the money is. I suppose as long as they keep us poor folk down, it makes them feel better about themselves. Poor egos I guess.

jhawkinsf 2 years, 2 months ago

According to the Dept. of Labor's web site, the Kansas minimum wage is the same as the Federal minimum wage.

Dave Trabert 2 years, 2 months ago

This story doesn't address the significant cost to Kansas taxpayers of expanding Medicaid. If the feds keep their promise...and exploding debt makes that less likely every day...federal tax dollars will pay the cost of new eligibles under Medicaid expansion but state taxpayers are on the hook for 60% of the cost of 'old eligibles'. Those are people who are currently eligible but not enrolled...but who will be forced to enroll because of the individual mandate.

Kansas Policy Institute's 2011 study, conducted by a sitting member of the Social Security Advisory Board, predicts 130,000 'old eligibles' will enroll in the first ten years of a Medicaid expansion and cost Kansans $4.7 billion out of the General Fund.

Kansas needs health care reform and there are many things the Legislature can do to make health care more affordable and accessible without spending more money. Remove restrictions on the formation of small groups (that benefit insurance companies)...allow purchase of policies across state lines (health insurance companies don't want the kind of competition that exists for car and homeowners insurance)...remove mandatory coverage requirements and allow Kansans to buy whatever health care coverage they want.

We need less government intervention in health care, not more.

verity 2 years, 2 months ago

I see words, but can't make any sense of them.

Is there someone out there who can interpret for me?

chootspa 2 years, 2 months ago

Grrrr, me thinks tax cuts gooood! Regulation baaaad! Free market fixes all! Pretend you do not notice that my biggest donor now pays no state taxes and has been enjoying a deficit-exploding federal tax cut because now I'm suddenly concerned about federal deficits.

chootspa 2 years, 2 months ago

So - you think the Kochs are not the biggest donor for the Kansas Policy Institute? If you've got data to back that up, I'd love to see it. Old Dave doesn't believe in transparency when it comes to disclosing KPI finances, but he's never flat out denied getting most of his money from the Kochs. Instead he's tried for weasel words like "wide and growing base" of (secret) donors.

Now about that state taxes thing. The Kochs will clearly from the recent tax changes, which exempt the owners of partnerships, sole proprietorships and other businesses from income taxes. That's right. Exempt. As in none.

Trumbull 2 years, 2 months ago

Encourage small pools? Large insurance pools (ie Business Groups and even a Public Option) should be encouraged. Large is always the better approach when it comes to insurance and risk minimization. Large.

chootspa 2 years, 2 months ago

Agreed. An insurance pool of every single person in the USA would do wonders for lowering costs and increasing the efficiency of coverage. Funny, I don't think ol' Dave would agree with that idea, though.

chootspa 2 years, 2 months ago

No. Insurance is based around profit. The inefficiency of care occurs at the profit skimmed by insurers and then again at the profit skimmed by providers monetarily incentivized to perform unneeded tests. Both would be removed under a single-payer system. Far from punishing healthy people, a single payer system can allow doctors to emphasize healthy habits and preventative medicine.

chootspa 2 years, 2 months ago

Taxpayers will be on the hook for those "old eligibles" either way, so the choice is use federal money wisely or let some other state use our federal money while we get nothing.

The only way the feds reneg on their promise is if they manage to repeal the law in the next two years, and they just don't have the votes. Besides, the CBO scored the ACA as saving money in the long term, not contributing to the "exploding deficit" - unlike that sweet, sweet tax cut your Koch overlords enjoy. Your argument could get sillier, but you're just going to have to try harder next time, because you've set the bar pretty high.

tomatogrower 2 years, 2 months ago

"Remove restrictions on the formation of small groups (that benefit insurance companies)...allow purchase of policies across state lines (health insurance companies don't want the kind of competition that exists for car and homeowners insurance)...remove mandatory coverage requirements and allow Kansans to buy whatever health care coverage they want."

The "Obamacare" exchanges plan on doing just those things, yet you people are against it. Makes my head spin trying to keep up with your flips and flops. Join a circus.

chootspa 2 years, 2 months ago

It kills me that they adopt what was essentially the Heritage Foundation plan, and the Kochlitarians still don't like the idea because it was a democrat who signed it into law.

Trumbull 2 years, 2 months ago

I was wondering about that too. The exchanges are more of a free market approach...ie by removing restrictions.

Trumbull 2 years, 2 months ago

Expansion of Medicaid will insure more children, working poor, and those without jobs. And getting more people insured will take pressure off of those who pay the most......those who are insured and employers who provide insurance. These are hidden costs as well.

leaningleftist 2 years, 2 months ago

Blah blah blah, Dave trabert, blah blah blah

Trumbull 2 years, 2 months ago

During the holidays I talked to some of my friends who I don't see much. Their biggest issue with the ACA is the employer penalty (ie if they have 50 employees and do not provide an insurance plan).

I do not necessarily like this part either. If the Republicans were sincere, why don't they be reasonable and try to negotiate this part out of the bill instead of anti everything in the bill? I think they are trying to be difficult.

In my view, they should have never opposed the Public Option. If this were included, the ACA would have been much less objectionable. But because the option does not cater to the big insurance business, this worthy option was taken off the table. This is too bad.

Fred Mertz 2 years, 2 months ago

That penalty is resulting in layoffs or reduced hours to avoid the penalty.

Trumbull 2 years, 2 months ago

That is one of the reasons why I don't like it. I wish employers never got involved in providing health insurance. It is pricing American workers out of the labor market. A regulated private market or a public option or a single payor system is the way to go....in my opinion.

Cait McKnelly 2 years, 2 months ago

Which has nothing to do with the "50 employees" part of the bill. Those corporations screaming the loudest and cutting hours and laying off employees are huge ones like John Schlatter, of Papa John's, and Yum Foods, who own and franchise Taco Bell, KFC and Pizza Hut. Just these two corporations employ thousands of people. And yet McDonalds is taking the whole thing with equanimity, saying that the ACA will cost them less than what commodity fluctuations will. Sorry. Not buying it.

Katara 2 years, 2 months ago

People said the same thing about FMLA but it works well.

The only employers that are reducing hours and laying off people are ones who just want to make a political point and even now, they are backing down from that. John Schnatter is a good example of that.

Before: http://www.whas11.com/home/Health-care-reform-165482546.html

After: http://www.forbes.com/sites/rickungar/2012/11/21/papa-johns-schnatter-says-he-will-honor-obamacare-and-give-health-insurance-to-all-employees/

And it turns out that Obamacare really won't affect him much anyway as corporate Papa John's already provides health insurance to its corporate employees and since most of the franchises employ less than 50 employees, they aren't affected by the mandate either.

chootspa 2 years, 2 months ago

I'd rather see insurance decoupled from employment completely. It's the only way to encourage entrepreneurship and support small businesses.

blindrabbit 2 years, 2 months ago

For years, we Kansans have chided the Southern States for poor performance in public education, rates of poverty, rates in obesity, smoking rates, rates in Christian fundamentalism, Civil Rights denials, and just general backwardsness. Recently, with the departure of the moderate GOP and it's replacement with the Southern Types of thinkers in the TeaBagging Kansas GOP, Kansas is drifting to the Southern Style of governance. It seems that the leadership of Brownback and his minions are perfectly willing and able to lead the State into the insignificance hinterlands and backwardness he so champions, with little regards to the benefit of the State's residents.

Cait McKnelly 2 years, 2 months ago

This is BS and you, me and the kids down the block know it. Brownback is going to turn it down. Next up, he'll follow in the footsteps of Susana Martinez (Governor of NM) and force rape survivors to either prove they were "forcibly" raped or contact their rapists and sue them for child support before they will be allowed to receive any kind of state support. Oh and by the way, this includes survivors of incest.

Cait McKnelly 2 years, 2 months ago

How about the Old Testament story of the man who used his daughter as a meat shield and turned her over to be gang raped to save himself?

Silverhair 2 years, 2 months ago

Not expanding Medicaid is detrimental to the health of Kansas and is a poor financial decision for Kansans. We will still have to pay the taxes and without expansion, those with coverage continue to pick up the tab for the uninsured, so we pay in, but none of the federal dollars come back to the state and we are worse off financially. Our dollars go to other states. The expansion population is covered with 100% federal dollars. The state's share of the current Medicaid population is just over 40%.

Larry Sturm 2 years, 2 months ago

brownback should be charged with contemp for putting Kansas in the shape it is in with all the tax cuts.

Larry Sturm 2 years, 2 months ago

Not comitting is like going to beach and sticking your head in the sand.

Briseis 2 years, 2 months ago

Kansas is the 15th best run state in the union. California last.

http://247wallst.com/2012/11/27/the-best-and-worst-run-states-in-america-a-survey-of-all-50/3/

California wants Obamacare.

Kansas does not.

Briseis 2 years, 2 months ago

&With the lone exception of our military, government does nothing efficiently.&

Trumbull 2 years, 2 months ago

There have been a lot of recent examples of business being rather poor and inefficeient. AIG, Enron, and a host of others come to mind. I dunno.

Briseis 2 years, 2 months ago

Wait til 30 or 40 million more slobs are looking for a checkup. If you think it is expensive now...

Briseis 2 years, 2 months ago

That's the plan with Obamacare Independent Payment Advisory Board. The 47 million will replace them.

Briseis 2 years, 2 months ago

"Death Panels" ? You must be a Palin flunky.

Briseis 2 years, 2 months ago

-----The current rumpus is over ObamaCare’s “exchanges,” the bureaucracies that will regulate the design and sale of insurance and where 30 million people (and likely far more) will sign up for subsidized coverage.

http://online.wsj.com/article/SB10001424127887324556304578121012109574832.html?mod=WSJ_Opinion_LEADTop

Obama is in Big Corporate Insurance, Pharma, back pocket.

The Affordable Care Act barely passed and then barely survived Supreme Court review and the 2012 election. Now the entitlement is hurtling toward a truth-in-advertising moment and liberals are terrified that it won’t produce the results they promised. That was always likely given the central planning architecture of ObamaCare, but now the likes of Mr. Walker are declining to do their work for them and depriving them of scapegoats.

The day after ObamaCare passed, we invoked the “Pottery Barn” rule that Colin Powell once applied to Iraq: You break it, you own it. Washington is about to break it, and the states are saying they won’t be accomplices.

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