OPINION

Kansas legislators should follow the will of their constituents. It's time to pass Medicaid expansion.

By April Holman
Special to Gannett Kansas
April Holman

Randy Keith lost his health insurance when he lost his job last January. Then another job fell through because of the pandemic. The Wichita resident needs mental health care and dental care.

Like thousands of other Kansans, Randy and his wife, who receives unemployment benefits, are stuck in the “Medicaid coverage gap”: They earn too little to get federal financial help to buy a marketplace plan and too much to qualify for KanCare, Kansas’ version of Medicaid.

That’s because in Kansas, adults with children younger than 19 can qualify for Medicaid but only if their income doesn't exceed 38% of the federal poverty level. This low threshold makes it difficult for all but the lowest income parents to qualify.

The Kansas Legislature could help Randy and many others get covered by expanding eligibility for KanCare, something policymakers in Topeka have repeatedly failed to do.

While the American Rescue Plan provided further significant incentives for states to expand Medicaid to their most vulnerable residents, to date, none of the 12 states that have yet to expand have opted in.

While the ultimate policy goal is to have all states expand Medicaid coverage to their eligible residents, there is growing agreement that in the states where governors and/or state legislatures continue to refuse to expand there should be a federally administered path to coverage for people with incomes under 138% of the poverty line, or $36,570 for a family of four.

Our legislators must stop playing politics with Kansans’ health. They should listen to community members and faith, health care and business leaders who support expanding Medicaid and giving coverage to 165,000 more people in our state, including 7,400 veterans and their spouses and thousands of essential workers.

Thirty-eight states and the District of Columbia have expanded their Medicaid programs. Evidence there shows expanding Medicaid leads to better access to care and positive health outcomes for individuals, keeps rural hospitals from failing and boosts state economies.

Expansion would come with substantial federal support: The federal government would cover 90% of the cost for newly covered adults. Thanks to the American Rescue Plan Act, passed by the U.S. Congress in March, Kansas would receive a five percentage point increase in the federal Medicaid matching rate for two years — between $330 million and $468 million over that period.

All these things would be good for Kansas. And the majority of Kansans see the value of expanding Medicaid. According to last fall’s Kansas Speaks poll, about 64% of Kansans support KanCare expansion, and 72% think expanding Medicaid would help rural hospitals stay open.

But in Kansas Medicaid can only be expanded through legislative action — not through a ballot initiative representing the will of voters. Here’s what the state will gain if they make the right choice and expand KanCare:

• More workers healthy enough to participate in the workforce. A significant body of evidence shows health insurance coverage, including Medicaid, enhances physical and mental health.

• Insurance coverage for small businesses. Expansion states have seen important gains in insurance coverage among people who work for small businesses and for themselves.

• Economic stimulus and new jobs. A Kansas State University economist estimates that full expansion will create 13,000 jobs, $1.8 billion in increased economic output and nearly $75 million in new state and local tax revenue.

• Increased consumer spending and business revenue. When people have health care coverage, rather than being uninsured, they can use the dollars they save on medical costs for other things they need, like housing, transportation and food.

• Enhanced economic development and business recruitment. Most of the states at our borders have expanded Medicaid. Businesses are looking for healthy workers and communities and a strong health care system. Expanding KanCare will enable us to compete with our neighbors for new businesses.

• Continued access to care in rural areas. Four rural Kansas hospitals have closed in recent years. People in communities with no hospital have difficulty getting emergency care and surgery. When hospitals close, many people lose jobs. And rural hospitals have fared poorly in states without Medicaid expansion, which helps cover the cost of “uncompensated care” when people cannot pay their medical bills.

We Kansans want health care coverage for ourselves and for our neighbors. We’ve seen Medicaid expansion improve health care access for millions in other states. It’s time we said: “Why not here?”

April Holman is executive director of Alliance for a Healthy Kansas.