Thursday, July 12, 2012

Brownback mum on expansion of Medicaid under federal health care reform

By SCOTT ROTHSCHILD, The Lawrence Journal-World

TOPEKA — Several Republican governors have said they will not expand health care coverage for the poor under the Affordable Care Act.

But while Republican Gov. Sam Brownback has been an ardent opponent of the ACA, he has not given a definitive answer on whether he would expand Medicaid, which could impact more than 150,000 Kansans.

"He will make a decision after the elections," said his spokeswoman Sherriene Jones-Sontag.

While the U.S. Supreme Court recently upheld the ACA as constitutional, it ruled that the federal government couldn't penalize states that opt out of a Medicaid expansion outlined in the federal health care law.

That means states have the option of expanding coverage. Federal officials have said with the federal government picking up 100 percent of the cost for the first three years and 90 percent after that, the states should jump on board.

U.S. Health and Human Services Secretary Kathleen Sebelius, a former Kansas governor and state insurance commissioner, sent a letter earlier this week to governors, urging them to participate.

"Now that the Supreme Court has issued a decision, we want to work with you to achieve our ultimate shared goal of ensuring that every American has access to affordable, quality healthcare," Sebelius said.

But several Republican governors, such as Rick Perry of Texas, have told HHS they will not participate. Republicans have said the Medicaid expansion and federal subsidies under the ACA for people to purchase insurance are unsustainable expenses.

Brownback has remained silent on the Medicaid expansion. But the governor has indicated in numerous ways his opposition to the Affordable Care Act and supports its repeal.

When he was in the U.S. Senate, Brownback voted against the bill and was one of the speakers on a live video "PrayerCast" to oppose health care reform. As governor, last year, he sent back a previously approved $31.5 million federal grant to establish an insurance exchange where consumers could search for the best insurance for their needs and eligibility for subsides would be determined.

The expansion of Medicaid under the ACA would increase the number of those eligible to all non-elderly persons with incomes up to 133 percent of the federal poverty level, or $30,000 for a family of four. That would provide coverage to 151,000 Kansans who are not insured now, according to the Kansas Health Institute.