Tuesday, March 5, 2013

Even states opposed to Medicaid expansion are working on Medicaid expansion

By SCOTT ROTHSCHILD, The Lawrence Journal-World

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.