Saturday, February 23, 2013

Health care providers oppose Republican resolution to not expand Medicaid

By SCOTT ROTHSCHILD, The Lawrence Journal-World

Allowing more low-income people to get health coverage will save lives and boost the economy, health care providers said Friday as they urged legislators to reject a resolution that says Kansas isn't interested in expanding Medicaid under the federal Affordable Care Act.

But several Republican legislators supported the resolution, saying Medicaid expansion would be too costly, drive up the federal deficit, and they expressed general displeasure with the ACA, which was signed into law by President Barack Obama and is known as Obamacare.

After the hearing, House Appropriations Committee Chairman Marc Rhoades, R-Newton, said he would talk with fellow committee members to see if there was any interest in working further on House Concurrent Resolution 5013.

The measure indicates the Legislature's "intention not to expand Medicaid services in Kansas," under the ACA.

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 upwards of 150,000 more Kansans would be covered under the expansion. The federal government would pay all the costs of expansion for three years and then ratchet that down to 90 percent of the cost over the next several years.

The influx of dollars would help the economy, while getting early medical care to more Kansans, supporters of the ACA said.

But in bringing up the resolution, Rep. David Crum, R-Augusta, and chairman of the House Health and Human Services Committee, said he feared the federal government would be unable to keep its funding commitment because of budget problems, which would leave states on the hook for paying for the coverage.

But the Kansas Hospital Association said that without expansion of Medicaid, community hospitals statewide will lose $1.3 billion over 10 years. That is because the ACA pays for the expansion by phasing out federal funding that currently reimburses hospitals for the care of uninsured patients.

Tom Bell, president and chief executive officer of the KHA, urged the committee to hold off on consideration of the resolution to allow legislators more time to study their options. "This is not a slam-dunk," he said.

Several opponents of the resolution said it didn't make sense for Kansas tax dollars to go to other states that were expanding Medicaid.

Karen Endicott-Coyan, advocacy director for Mercy Hospitals in southeast Kansas, said she wanted those tax dollars to help people in Kansas.

"Take a thoughtful and prayerful approach to this problem," she told the committee.