Kansas may become the 42nd state in the nation to expand its Medicaid program.
Gov. Laura Kelly (D) proposed the Cutting Healthcare Costs for All Kansans Act on January 17. The Republican-led legislature is poised to reject her bill after leadership in December gave a thumbs-down on expansion.
North Carolina became the most recent state that approved Medicaid expansion in December, after much wrangling, and may provide a glimpse of what is in store in Kansas.
Individuals and families with incomes up to 138 percent of the Federal Poverty Level can qualify for Medicaid under expansion. For an individual and family of four in 2024, that would be $20,783 and $44,382, respectively.
‘Middle-of-the-Road’ Approach
Kelly has supported Medicaid expansion in Kansas for years, says Devon Herrick, a health economist who writes for the Health Bog of the Goodman Institute, which co-publishes Health Care News.
“Kelly claims her plan is ‘middle-of-the-road’ for advocating work requirements, but that’s a provision she has no authority to grant,” said Herrick. “Moreover, the Biden Administration opposes work requirements for welfare programs, and will be unlikely to agree to them.”
Kansas House Minority Leader Vic Miller introduced Kelly’s bill in the House Appropriations Committee.
“Medicaid expansion is not only popular, but it saves lives, creates jobs, and saves our rural hospitals,” said Miller, in a news release. “Hardworking Kansans shouldn’t die because of legislative inaction.”
“While polls claim a majority of Kansans support Medicaid expansion, a desire to protect rural hospitals is not a primary concern for most people,” said Herrick. “It is early but most political experts in Kansas doubt she will succeed.”
‘System Already Stretched Thin’
North Carolina’s expansion was the largest increase in government entitlements in the state’s history, says Brian Balfour, a senior vice president of research at The John Locke Foundation.
“North Carolina’s Medicaid program had already added about one million people in the two decades preceding the decision to expand,” said Balfour. “This occurred at a time when the number of doctors and hospitals serving Medicaid patients remained flat at best. Adding up to another 600,000 in a short period of time will further overwhelm a system already stretched thin. Who will Medicaid patients see when they get sick? Coverage does not equal ‘access to care.’”
If projections are correct, roughly one in three North Carolinians will be dependent on Medicaid for their health insurance coverage after expansion.
Hospital Tax Imposed
Gov. Roy Cooper (D) made Medicaid expansion a top priority for several years, putting him at odds with the majority-Republican legislature. Expansion was a sticking point in budget negotiations for years, prompting Cooper to veto the legislature’s budget in 2019.
“The clincher for the Republican-led General Assembly, though, was the federal government’s sweetener of an added $1.8 billion in federal funds over two years that came along with expansion,” said Balfour.
“Despite the added federal funds, North Carolina must still pay the state portion, via a new tax on hospitals, called an “assessment,” said Balfour. “This state share is estimated to cost $325 million and $482 million in the first two years, respectively.”
Kenneth Artz (KApublishing@gmx.com) writes from Tyler, Texas.