Topeka — Is Gov. Sam Brownback moving closer to siding with expansion of Medicaid under the federal Affordable Care Act?
In a two-minute question and answer session with reporters, Brownback, a Republican who opposes the ACA, said his administration is looking at options and alternatives.
"We're still working on Medicaid, what we can do that we could make it work," he said.
Brownback then talked about wanting to make sure the state budget was in good shape and that when he took office in 2011, he was facing a shortfall "after the Sebelius administration."
Former Gov. Kathleen Sebelius, a Democrat, left Kansas to become President Barack Obama's secretary of the U.S. Department of Health and Human Services. Sebelius was succeeded by Mark Parkinson, the former lieutenant governor, who had to deal with record revenue shortfalls during the Great Recession. Ironically, it's Sebelius, as HHS secretary, who is working with governors considering Medicaid expansion.
While many Republican governors, including Brownback, have been critical of Medicaid expansion, some are warming to the idea since the federal government will pay for the first three years, and 90 percent of it after that. Some have also said that it would be unwise for a state to leave federal money on the table for other states to take.
Missouri Gov. Jay Nixon, a Democrat, has been trying to persuade Republican legislative leaders to get on board. Earlier this week, Nixon said that if Missouri were to reject expansion of Medicaid it would become like a town from the 1860s that refused a railroad or a city from the 1960s that rejected an interstate highway. In Kansas, estimates indicate that Medicaid expansion would extend coverage to 200,000 more people.
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 less than $6,000 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 $31,000 per year for a family of four.
In the Legislature, Senate President Susan Wagle, R-Wichita, has been open to the idea of expanding Medicaid, while House Speaker Ray Merrick, R-Stilwell, hasn't.