Archive for Friday, February 8, 2013

Statehouse Live: Brownback administration releases estimate on expanding Medicaid, $600 million over 10 years

February 8, 2013


— Expanding Medicaid under federal health reform will cost Kansas approximately $600 million over 10 years, according to an executive summary of a study released Friday by Gov. Sam Brownback's administration.

The study done by actuaries at the consulting firm Aon Hewitt said Medicaid expansion would cost the state $1.1 billion over 10 years. Medicaid expenses are projected to increase $513.5 million without the expansion for a difference of about $600 million.

The one-and-a-half page executive summary was released by the Kansas Department of Health and Environment, which said the full report will be available next week.

"We look forward to working with the state Legislature in the coming weeks to discuss the findings as the members deliberate the impact of expansion,” said KDHE Secretary and State Health Officer Dr. Robert Moser.

Brownback has said he is undecided about whether to support the option of expanding Medicaid under the Affordable Care Act.

But a statement from his spokeswoman, Sherriene Jones-Sontag, indicated the governor was disinclined to expansion of Medicaid.

“For Kansas to expand the Medicaid program as the ACA requires, the state would need more than $1 billion dollars in new expenditures," Jones-Sontag said.

"This impact would be significant and would directly affect the ability of the state to fund other core responsibilities like K-12 education and public safety. And if the federal government fails to keep its promise to pay for its part of the expansion, the direct impact would be even greater.

"The governor looks forward to working with the Legislature as the state determines the path forward for Medicaid and identifies the most effective and sustainable solutions for our state’s unique public health care system," she said.

Opponents have said it would cost too much, but health care advocates have said more people covered by Medicaid will lower health care costs statewide as those covered will stop relying on emergency-room care. They also argue more coverage will save lives.

State Rep. Jim Ward, D-Wichita, who supports the expansion, said the actuary's figures are doable.

Ward said 185,000 additional Kansans can receive health care coverage for $60 million per year. And for the first three years of the expansion, the federal government picks up the entire expense.

"That is a pretty good deal," Ward 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 Affordable Care Act 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.

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.

But in recent weeks, some states led by Republican governors, such as Arizona, Michigan and Ohio, have said they will expand Medicaid.


just_another_bozo_on_this_bus 4 years, 9 months ago

Brownback just figures it'll be cheaper to scrape them all off the curb once they stop breathing.

Patricia Davis 4 years, 9 months ago

Actually JABOTB, I think the plan is more like getting the poor and the sick to move out of Kansas because they really can't stand them because they aren't like the annointed ones. Kind of like a do it yourself final solution.

veggiegirl 4 years, 9 months ago

Hoping the report includes the additional costs to hospitals (and thereby the public) of loss of the Medicaid disproportionate share payments, as well as how much in federal dollars the state stands to lose if Governor Brownback chooses to not expand Medicaid.

Arizona, Ohio, Michigan, Nevada, New Mexico, and North Dakota, all with Republican governors, have said they support Medicaid expansion. This will be a true test to whether Governor Brownback is more interested in policy or politics.

Bike_lover 4 years, 9 months ago

Hosptials will raise rates for insured patients to pay for un-reimbursed care for the uninsured. If Brownback is so concerned about making Kansas a magnet for industry how can he take actions that will make the states insurance rates higher for everyone? States that accept the Medicaid expansion will have lower rates for private insurance.

If he's not interested in attracting industry with jobs that provide private insurance he should be honest about it so the good people of the state can show him the door at the next election.

George_Braziller 4 years, 9 months ago

I think his political career is over after he leaves office. He's bringing Kansas national attention but not the kind he wants.

Michael LoBurgio 4 years, 9 months ago

Another GOP governor likes the Medicaid expansion

Another conservative Republican governor, Ohio’s John Kasich, is getting in on the Medicaid expansion.

He joins the Republican governors of Arizona, New Mexico, North Dakota and Nevada in announcing he’ll accept federal money in order to raise Medicaid eligibility limits to 133 percent, as called for in the Affordable Care Act.

For those keeping score, 20 governors have announced they’ll participate in the expansion, though some, like Missouri Gov. Jay Nixon, face a challenge from their legislatures. The rest of the states are either undecided or leaning one way or the other but not yet committed.

In reading this Associated Press account of Kasich’s announcement, I am struck by how much Kasich, a very conservative Republican, sounds like Nixon, a pretty conservative Democrat.

“I don’t believe in the individual mandate,” Kasich said. Neither did Nixon, when the mandate was a red-hot issue last year and deeply unpopular in Missouri.

“But I think that this makes great sense for the state of Ohio,” Kasich said of the Medicaid expansion. Nixon has said the same of Missouri.

Kasich also pointed out that if Ohio doesn’t expand Medicaid eligibility, federal taxes paid by Ohioans will go to expand Medicaid in other states, and businesses elsewhere will gain an advantage by creating a healthier workforce. Pretty much the same arguments made by Nixon.

Also, both Kasich and Nixon are proposing a safety valve, which would automatically lower Medicaid eligibility in states if the federal government reneges on its funding commitment.

Pick your takeaway from all of this: 1) Kasich, known as one of the nation’s must tight-fisted governors, isn’t as conservative as he’s billed to be, or 2) Nixon is a trendsetter or 3) Whatever your political bent, the Medicaid expansion makes sense.

The smart money is on Takeaway No. 3.

Read more here:

Michael LoBurgio 4 years, 9 months ago

Missouri governor pushes for Medicaid expansion

The word shot through Missouri’s medical care community last Wednesday — in a series of news conferences the next day, Gov. Jay Nixon would announce his support for expansion of the state-federal Medicaid program for the poor.

Read more here:

Michael LoBurgio 4 years, 9 months ago

Brownback's Medicaid study not the full story

The Aon Hewitt study falls somewhere in the middle of what a few other studies predicted it would cost the state to expand Medicaid.

But — and this is a big omission — I haven’t yet seen a study out of Kansas that includes offsets. What would the state save in mental health costs, for instance, by getting that population into Medicaid? Would it save money on uncompensated care expenses to hospitals? Is the state paying health care for disabled citizens and other populations who could be covered by Medicaid?

In Missouri, Gov. Jay Nixon’s budget experts tallied up these offsets and figured the state would come out with a net gain by expanding Medicaid.

Setting aside the irony of Brownback’s decision to decimate the state’s ability to fund core services with his income tax cuts, one has to wonder why the governor doesn’t consider health care for working Kansans who can’t afford insurance and don’t receive it from their employers to be a core responsibility.

Read more here:

question4u 4 years, 9 months ago

Expansion of Medicaid will interfere with the core function of government: assuring that business owners in Kansas pay no state income tax. It's the same reason that even workers earning minimum wage will get a permanent sales tax increase on their food purchases under Brownback's plan. It's also why the plan calls for middle class homeowners to pay more in property tax, and why funding of Kansas schools has to be cut back to pre-21st century levels.

It's worth it for Kansas to become the least humane state in the nation so long as business owners don't have to pay state income tax. We can all have the morals of a coyote or Sherriene Jones-Sontag and not have to feel any remorse, so long as businesses pay no state income tax.

Katara 4 years, 9 months ago

Your statement is very unfair to the coyote.

Michael LoBurgio 4 years, 9 months ago

Alert this was floating around the capital friday..............

Capitol hall talk is that there are efforts afoot by Governor Brownback to make all Kansas state employees "unclassified," essentially eliminating their civil service protections.

If this is true, all state employees would serve at the pleasure of the governor and could be dismissed for having the "wrong politics." Civil service protections exist to ensure that public employees aren't hired and fired based on their political beliefs.

There's no bill or executive order yet - hopefully Governor Brownback will swiftly put this rumor to bed.

Larry Sturm 4 years, 9 months ago

That is why everybody should pay taxes. The young help the old and disabled that someday they may be in the same position.

Orwell 4 years, 9 months ago

How perceptive. Make the minimum-wage household pay higher axes, so we can "afford" to treat them forever for malnutrition and resulting chronic illness.

Larry Sturm 4 years, 9 months ago

It will take 50 years to undo the damage that Brownback has done to the state of Kansas in 4 years.

Lenette Hamm 4 years, 9 months ago

Wait... what? I thought KanCare is supposed to SAVE Kansas millions. Tired of his rhetoric.

Orwell 4 years, 9 months ago

In addition to the poor you can say goodbye to the next generation of educated Kansans. Finish school, move to a state where there's available health care coverage for a young family.

Orwell 4 years, 9 months ago

I'm also interested in seeing how Brownback stacked the deck with negative assumptions in ordering this study. If you think it was objective you haven't been paying attention to his alternate-reality propaganda and tactics. See, e.g., the phantom $30 million "savings" from merging KTA & KDOT.

Meg McNelly Schimmels 4 years, 9 months ago

But if the Guv and his trickle down economic beliefs are to be believed, Kansas won't have a shortage of cash because of all the corporations moving here and the economy will blossom like spring dandelions, and we'll have zero unemployment, and all our schools will have children who will be above average and THE ANGELS WILL SING! So why not expand Medicaid because in Future Kansas World, there will be more money than we'll know what to do with!

Commenting has been disabled for this item.