Topeka 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.