- Policy & Research
- About KHI
Aug. 29, 2013
KHI News Service file photo
WICHITA The chief executive of one of the state’s largest medical centers this week urged Kansas legislators to consider expanding eligibility for the state’s Medicaid program.
The original intent of the Affordable Care Act, commonly known as Obamacare, was that all states would expand their Medicaid programs effective Jan. 1, 2014 to include all adults with incomes at or below 138 percent of federal poverty guidelines.
But a subsequent U.S. Supreme Court ruling made expansion optional for states. Kansas, which is governed by conservative Republican opponents of Obamacare, is among the states that have shown no interest in broadening the program, despite entreaties from Kansas hospital officials and other groups.
Kansas currently has one of the nation’s most restrictive Medicaid programs, essentially barring all childless adults regardless how poor, unless they are elderly, disabled, or pregnant. Parents can qualify if they have income below 32 percent of poverty guidelines, which is less than $550 a month for a family of three.
Once the other coverage mandates of the Affordable Care Act kick in on Jan. 1, people with incomes between 100 percent and 400 percent of federal poverty guidelines will be eligible for federally subsidized private health coverage. But since state policymakers haven’t approved Medicaid expansion, a large number of Kansans — an estimated 58,000 — will be ineligible for the program but too poor to meet the subsidy thresholds.
“Even with the Affordable Care Act, we’re still going to have a lot of people who won’t be in a position to take advantage of the health insurance marketplace,” said Hugh Tappan, chief executive of Wichita’s Wesley Medical Center.
“They’re still going to come to us and we’re still going to see them, regardless of their ability to pay. But we need to be figuring out how a system that assumes everybody will be insured goes about covering the costs of the uninsured,” he said.
Tappan met with Wichita-area legislators in meetings on Monday and Tuesday and voiced various concerns, including problems he said the hospital has had getting paid for Medicaid services it has rendered.
“The idea of a mom and a dad with a child not being eligible for Medicaid unless they were under 32 percent of poverty — that’s a concern,” he told KHI News Service in a follow-up telephone interview.
Tappan also alerted legislators to the anticipated financial impact to Wesley if there is a 2 percent reduction in Medicare payments as a result of the federal budget sequester.
“Two percent is a lot,” he said. “We probably should have done more to let people know about it, but we were all too busy dealing with KanCare.”
The Kansas Health Consumer coalition also is working to persuade Kansas policymakers to open up the Medicaid program to more people, and the Kansas Hospital Association earlier this year began a separate campaign pushing for expansion.
According to studies commissioned by the hospital association, Medicaid expansion would pump more than $3 billion into the state economy and create 4,000 new jobs by 2020.
But the state's Republican political leaders have said they are unconvinced the federal government would continue to cover the costs of new Medicaid enrollees, eventually leaving the state to either pick up the tab or cut people from the program.
The hospital association also did a poll that showed 60 percent of Kansans favored Medicaid expansion.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute. It is supported in part by a variety of underwriters. The News Service is committed to timely, objective and in-depth coverage of health issues and the policy-making environment. All News Service stories and photos may be republished at no cost with proper attribution, including a link back to KHI.org when a story is reposted online. An automatically updated feed of headlines and more from KHI can be included on your website using the KHI widget. More about the News Service at khi.org/newsservice or contact us at (785) 233-5443.