The health reform proposals being pushed by the Obama administration and debated in Congress would accomplish something that Kansas lawmakers two years ago refused to do — provide government coverage to low-income adults.
Fearing the cost, legislators rejected a Kansas Health Policy Authority proposal to help parents living at the federal poverty level and just beyond to purchase private insurance. Several of the legislators who opposed the idea said it was tantamount to expanding Medicaid, the $2.4 billion government health insurance program for the poor that is jointly paid for by the state and federal governments.
Dramatic in Kansas
Two of the three leading health reform bills now in Congress would expand Medicaid. The expansion would be especially dramatic in Kansas, where currently low-income adults aren’t eligible for the program unless they care for children and then only if they make less than 27 percent of the Federal Poverty Level — about $3,250 a year for an individual or $5,500 annually for a family of three.
The health reform bill under consideration in the U.S. House would make adults eligible for Medicaid if they earn less than 133 percent of poverty, about $14,400 a year for an individual or $24,350 a year for a family of three.
No one has precise numbers yet, but it is thought that the House bill, if approved, would add at least 100,000 people to the Kansas Medicaid rolls, which in June included about 265,000 people.
“Like everyone else, we’re just now getting a look at the details of the bill,” said Andy Allison, executive director of the health policy authority, the state agency that manages Medicaid. “We’re monitoring the developments in Washington closely and staying in contact with the Kansas delegation so that we can fully inform state lawmakers next year about the proposals and how they might affect programs that are administered by the state.”
Beyond possibility
Earlier this month, several of the nation’s governors gathered for their annual meeting said they were concerned an expansion of Medicaid would worsen already dire budget situations in their states. It’s a concern shared by the Rep. Kevin Yoder, R-Overland Park, chairman of the House Appropriations Committee.
“The very notion that we would dramatically expand state spending on health care at this point is completely out of the realm of possibility,” Yoder said, noting that the state is facing a potential shortfall of $530 million in the coming budget year.
Whether the fears of state policymakers are justified will depend on which, if any, version of the health reform bill passes Congress. Under the House bill, the federal government would pick up all of the cost of providing coverage to those added to the Medicaid rolls, which the nonpartisan Congressional Budget Office estimates could total more than $500 billion over 10 years.
But under reform legislation being negotiated by a handful of members of the Senate Finance Committee, the federal government would pick up only the first several years of the cost before asking the states to pay a share.
Potential impact
Tom Bell, president of the Kansas Hospital Association, said his members support the idea of expanding Medicaid.
“But we can’t look at this without also talking about its potential impact on the state,” Bell said. “You have to see both sides.”
State officials fear that even the House bill would increase the cost of Medicaid for states because people who are now eligible but not enrolled would be required to obtain coverage.
-Jim McLean is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at jmclean@khi.org or at 785-233-5443, ext. 110.