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Even states opposed to Medicaid expansion are working on Medicaid expansion


Topeka — In Kansas, Gov. Sam Brownback and his conservative Republican colleagues in the Legislature seem to be following the no-way, no-how lead of Texas Gov. Rick Perry on whether to expand Medicaid under the federal Affordable Care Act.

But this story link text in the San Antonio Express-News shows that not all is as it appears in Texas.

While Perry, whom Brownback backed for the Republican nomination for president, is taking a tough-guy stand against Medicaid expansion, key legislators in the Lone Star State are working behind the scenes for a "Texas solution."

And there may be more acceptance in conservative Republican circles for a proposal by Arkansas that has apparently gotten the green light form Health and Human Services Secretary Kathleen Sebelius, a former Kansas governor. This bloglink text reports that Sebelius has said OK to the plan to use Medicaid dollars to buy private insurance.

So far, Brownback says he is undecided on whether to opt in to expanding Medicaid in Kansas, although whenever asked he says he worries about the costs and notes the state's budget problems — problems caused by income tax cuts he signed into law last year.

And conservative Republicans in the Legislature are pushing a resolution opposing the expansion of Medicaid. Hospitals and health care groups oppose the resolution. In addition, a statewide poll conducted on behalf of the Kansas Hospital Association found that 60 percent of Kansans support expanding Medicaid.

Under the Affordable Care Act, the federal government would pay the entire cost of the expansion for three years, and then that share would fall down to 90 percent after that.

Currently, Medicaid provides health care coverage to about 380,000 Kansans. The largest portion of them, about 230,000, are children. The rest are mostly lower-income, pregnant women, people with disabilities and elderly people. 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 are that expansion would cover upwards of 150,000 more Kansans.


Greg Cooper 5 years, 1 month ago

Well, what did they expect? As Sam's house of cards begins to tumble, even those who have been such staunch "conservative" supporters of wrecking the Kansas economy in the name of "smaller government" and "controlled spending" are begining to see what they have wrought.

The big thing, now, Mr. Brownback, is to admit to the citizens that there may be another way to run the state other than by Koch edict. Admitting a mistake is not a bad thing, so long as you work, really, really work, to rectify the mistake. Leaving tens of thousands without adequate medical care, especially at no cost to the state, and denying the jobs and tax revenues that will materialize, is not moral, nor is it good state business.

Admit it, Sam, you have only one way to go, and that is the way that is better for the state's people.

Cant_have_it_both_ways 5 years, 1 month ago

I am not so sure this is not the right thing to do. I can not imagine when working people really find out how hard this is going to hit them in the wallet, they don't demand a huge overhaul of the ACA or get rid of it altogether and start over. This in no way fixes things for those who cant afford coverage, the only thing it does is add a level of bureaucracy to things that only consumes scarce dollars intended for health care. Does anyone really trust the feds to stay at that 90% after 3 years, or will this become another unfunded mandate? I don't pretend to know the answer, I do think they are not treating the real problem. When you have laws that say you have to provide care to anyone who walks into the emergency room when they could be treated at a much lower level, you don't build more emergency rooms. Ask around to people you know that have jobs and see if they are not paying more now for coverage or getting their hours cut.

Katara 5 years, 1 month ago

That is not what the law says.

"The "duty to treat" that EMTALA imposes on hospitals with emergency rooms that accept Medicare and Medicaid reimbursement begins when a patient comes to the emergency department seeking help. In addition to the emergency department, EMTALA also applies to other properties owned by a hospital, such as ambulances. To comply with EMTALA, the participating hospitals must provide within its capabilities a nondiscriminatory medical screening examination (MSE) to determine if the patient has an emergency medical condition. An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity, such as severe pain, for which the lack of immediate medical attention could reasonably be expected to result in placing the patient in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part." http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=146&Itemid=172

It also includes women in active labor.

But it doesn't require a hospital to treat an ear infection, broken toe or your sniffles. And it doesn't apply to hospitals that don't participate in Medicaid or Medicare.

chootspa 5 years, 1 month ago

Actually Brownback has it in his best corporate funded heart's interest to expand Medicare, since he privatized it to Kancare. I'm sure he'd love to kick some moolah to some potential campaign donors, as long as he can figure out a way to sell to the tea partiers.

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