Editorial: Medicaid barriers

Despite additional evidence of the benefits of expanded Medicaid coverage in Kansas, the issue seems unlikely to gain traction in the coming legislative session.

Although a study released last month indicated that Kansas would at least break even or perhaps realize financial benefits from expanding its Medicaid program, there seems to be little chance that expansion even will be discussed in the upcoming legislative session.

The study commissioned by six health foundations, including the Kansas Health Foundation in Wichita, analyzed data from other states that have expanded Medicaid and applied it to the Kansas budget through 2020. (Thirty states and the District of Columbia have approved an expansion plan.) The study laid out benefits that would result from Kansas dollars being replaced by federal dollars, savings from higher federal matches and potential new revenues from fees that would result from higher Medicaid enrollment and concluded that those dollars would more than cover the cost of Medicaid expansion.

Legislative leaders who oppose that expansion were quick to discredit the study, saying that the firm that conducted it was biased and that a five-year analysis was too narrow. However, they didn’t present any hard data to repute the study’s conclusions.

The study results directly address one requirement Gov. Sam Brownback has set for any expansion plan: that it be revenue neutral for the state. However, during a recent interview with the Journal-World, Brownback repeated his other two conditions: The plan must include a work requirement for able-bodied adults and start by eliminating the existing waiting list for current Medicaid recipients to receive in-home services.

Brownback’s concern for those on the waiting list could be drawn into question by his administration’s decision in November to use $25 million in excess Medicaid funds to help fill the state’s budget hole. When a state legislator asked Budget Director Shawn Sullivan if that money could have been used to reduce the waiting list, he replied, “Yes, we could do that, but in our case we’re helping with the state general fund shortfall.”

So, reducing the number of people on the waiting list by an estimated 25 percent wasn’t exactly a top priority — although leaving one of the obstacles to Medicaid expansion in place might be considered a side benefit by opponents to that action.

With state legislators facing re-election campaigns and eager to have a short, non-controversial session, it seems unlikely that any plan for Medicaid expansion will be seriously considered this year. That’s not good news for the estimated 150,000 uninsured Kansans who would receive health care through an expanded Medicaid program — or for the hospitals and health professionals who would provide that care.