It came as no surprise, but it was still disappointing that Gov. Sam Brownback on Thursday vetoed a bill that would extend Medicaid coverage in Kansas, with most of the expense paid by the federal government.
The bill would expand Medicaid coverage, or KanCare, under the Affordable Care Act to all individuals with incomes up to 133 percent of the poverty level. State officials estimate that would extend coverage to an additional 152,000 people in Kansas.
The bill has broad bipartisan support and now goes back to the House and Senate for possible veto overrides. Though the bill passed both chambers by strong margins (81-44 in the House and 25-14 in the Senate), overriding the governor’s veto will require 84 votes in the House and 27 votes in the Senate.
Currently, Kansas has one of the strictest eligibility requirements for Medicaid of any state. It is available only to pregnant women, children, disabled adults and seniors who meet certain income guidelines. The Affordable Care Act offers federal reimbursement to states to extend Medicaid to those younger than 65 whose family income is at or below 133 percent of federal poverty guidelines. The federal government paid for 100 percent of the Medicaid expansion for 2014 through 2016. Federal funding dropped to 97 percent this year and will gradually decrease to 90 percent by 2020.
Kansas is among 19 mostly conservative states that have thus far refused to participate in Medicaid expansion out of opposition to Obamacare.
“I am vetoing this expansion of ObamaCare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs,” Brownback said in vetoing the bill. “Most grievously, this legislation funnels more taxpayer dollars to Planned Parenthood and the abortion industry.”
The Kansas Department of Health and Environment says the expansion would cost the state roughly $81 million in the upcoming fiscal year. But there is no denying the significant federal funding Kansas has foregone by not expanding Medicaid coverage. The Kansas Hospital Association estimates Kansas has missed out on more than $1.7 billion in federal funds by not participating in expansion since the program began on Jan. 1, 2014.
State Medicaid officials have said that when fully implemented, the bill would bring in close to $1 billion a year in additional federal reimbursement.
“Expansion also means rural hospitals, clinics, mental health centers and other health care providers remain open by reducing the cost of uncompensated care,” Senate Democratic Leader Anthony Hensley, of Topeka, said. “Further, it creates more than 3,800 new jobs.”
Obamacare may need reform, but aspects of the legislation, including Medicaid expansion, have proved extremely popular. And it’s hard to argue that Kansas, which has experienced rural hospital closings and has approximately 80,000 residents without insurance, has benefited from not participating in Medicaid expansion.
It’s time to expand Kancare. Let’s hope the Legislature can muster the handful of votes necessary to override the governor’s ill-advised veto.