Friday, November 21, 2014

Kansas hospitals continue campaign for Medicaid expansion

By Jim McLean
KHI News Service

TOPEKA, KAN. — The Kansas Hospital Association on Thursday continued its campaign for Medicaid expansion by reminding policymakers how much the state is losing by not claiming federal dollars to cover more low-income adults.

The association released a report based on analysis done by the Center for Health Policy Research at George Washington University and Regional Economic Models Inc.

“If Kansas does not expand KanCare by 2016, more than $2.2 billion in federal matching funds will be lost between 2016 and 2020, stifling economic and employment growth,” the report said.

KanCare is the name of Kansas’ privatized Medicaid program, which is administered by three for-profit managed care companies.

The conclusions in the most recent KHA report are similar to those reached by the nonpartisan Urban Institute, which issued a report in August that pegged Kansas’ losses between 2013 and 2022 at $2.6 billion and Missouri’s at $6.8 billion.

Kansas hospitals have been lobbying for Medicaid expansion for two years, but Gov. Sam Brownback and the Legislature have refused to take up the issue.

This session, Tom Bell, chief executive of KHA, has said the association will be more aggressive in promoting its own bill. The legislative proposal will be unique to Kansas and build on the state’s already privatized system. Bell has said he has received signals from the Brownback administration and key legislators that with the election behind them they may now be willing to consider a proposal.

“Yes, we’ve had folks in the administration that have indicated that after the election this would be a different kind of discussion,” Bell said. “And we’re counting on that. We certainly plan to move forward.”

Brownback spokesperson Eileen Hawley didn’t immediately respond when asked whether the governor is now more open to discussing expansion.

Twenty-eight states and the District of Columbia have expanded Medicaid eligibility, while Kansas and 20 other states have not. Policymakers in two states are considering the issue, according to the nonpartisan Kaiser Family Foundation.

Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) increased by 23 percent from October 2013 to October of this year in the states that have expanded Medicaid eligibility, according to the U.S. Department of Health and Human Services. By contrast, enrollment has grown by only 6 percent in the states that haven’t expanded eligibility.

The KHA report also attempts to make an economic case for expansion, saying that it would create nearly 4,000 jobs by 2020, about half of which would be health care jobs.

“This ripple effect occurs because KanCare funding, received by hospitals, clinics or drug stores, is used to pay workers’ salaries and to buy other goods and services,” the report said. “The economic benefits multiply as these funds are, in turn, used to pay for mortgages or rent, buy food and pay state and county taxes.”

The KHA report estimates that expanding KanCare eligibility would allow 100,000 low-income adults to gain coverage in 2016 and another 144,000 in 2017. Generally speaking, adults who make more than 32 percent of the poverty level — annually about $3,730 for an individual and $7,630 for a family of four — are not currently eligible for KanCare. Expansion would expand eligibility to those who make less than 138 percent of the poverty level — about $16,100 for an individual and $32,900 for a family of four.

The Affordable Care Act obligates the federal government to pay 100 percent of expansion costs through 2016. The federal share declines to 95 percent in 2017, then to 90 percent by 2020. The KHA report estimates that expansion would add $312 million to the cost of KanCare between 2016 and 2020.

That additional cost could prove to be a big stumbling block given the state’s mounting budget problems. The governor and lawmakers need to cut spending or raise taxes to prevent a $280 million deficit in the current budget year, according to official revenue projections revised earlier this month . Revenues are projected to fall $436 million short of anticipated expenditures in 2016, the estimates show.