Advocates seek Medicaid expansion to fix Kansas’ ‘donut hole’

The Senate launched into back-to-back days of public hearings Monday on legislation compelling the administration of Gov. Sam Brownback to expand Medicaid health services to people earning too much to qualify for the state’s existing program and too little to secure federal help to buy private insurance.

 

Proponents of House Bill 2044 argued the “budget neutral” legislation was a responsible approach to filling the service gap among approximately 150,000 low-income adults in Kansas, while opponents of the bill approved by the House have an opportunity Tuesday to offer their perspectives to the Senate Public Health and Welfare Committee.

Suzan Emmons, a self-employed resident of Allen County, said she was one of the 150,000 reasons to expand KanCare, which is the Kansas version of Medicaid. Emmons is raising her two grandchildren, but hasn’t had health insurance for two years. She would have to pay $499 per month for coverage. Absent expansion, she said, her family will remain in the coverage “donut hole.”

“I’m frustrated, and sometimes angry, that I now live in constant fear about what I’ll do if I get sick,” she said. “I am employed. I contribute to our state. I stepped up for my granddaughters and am doing my best to help them succeed. But I need your help. If something happens to my health and I can’t treat the problem, our family unit breaks down.”

A rainbow of Kansas advocacy organizations have sought for years to expand Medicaid under the Affordable Care Act signed by President Barack Obama, but Brownback and Republican allies in the Legislature have successfully blocked efforts to broaden eligibility. For the past three years, a state’s expansion under the ACA has been paid by the federal government. Thirty-one states adopted some version of expansion.

Under the House bill, the Kansas Department of Health and Environment would be required to modify eligibility requirements after Jan. 1 to include any non-pregnant adult under 65 years of age, who is a U.S. citizen or legal resident and who has been a resident of Kansas for at least one year, whose income does not exceed 133 percent of the federal poverty level.

Uncertainty surrounds debates in Topeka and elsewhere on the future of Medicaid because President Donald Trump has pledged to overhaul key elements of the ACA.

In February, Brownback said repeal of the ACA should be done in a “politically sound” manner that preserved coverage for people with incomes up to 133 percent of the federal poverty level.

David Jordan, executive director of the Alliance for a Health Kansas and a chief proponent of expansion, said the issue of whether or not to reform KanCare had implications for every Kansas taxpayer.

“To date, the state has forfeited over $1.6 billion of Kansas taxpayers’ money because we have chosen not to expand KanCare,” Jordan said. “That money could have been brought back to Kansas to create jobs, protect hospitals and local taxpayers, and improve the health of Kansans.”

Expansion under current federal law would inject $1 billion into the state’s health care system during the first year of implementation, said Fred Kerr, a former state senator from Hutchinson. The cost to the state would be about $81 million, he said.

Jeremy Presley, a Dodge City doctor speaking on behalf of the Kansas Academy of Family Physicians, said he cared for patients each day who didn’t have health insurance.

“The Hippocratic Oath talks about our obligation to all of our fellow human beings,” the physician told senators. “You have the opportunity with this expansion bill to do something good for our state.”

 

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