Kansas hospitals want to hit ‘reset’ button on Medicaid expansion debate

Hospital association hires former Bush HHS secretary to help craft a plan Kansas Republicans might support

0 | Advocacy, Hospitals, Medicaid-CHIP

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Photo by Dan Bammes / KUER.org

Former HHS Secretary Mike Leavitt.

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— The Kansas Hospital Association has hired former U.S. Health and Human Services Secretary Mike Leavitt to help craft a Medicaid expansion plan that Gov. Sam Brownback and Republican legislators might support.

Tom Bell, KHA’s president and CEO, said he hopes that Leavitt — a former Republican governor of Utah who headed HHS under former President George W. Bush — can help Kansas policymakers craft a plan similar to those developed in Arkansas and Iowa, which expand Medicaid through the use of private insurance companies.

“We ought to as a state be having a conversation about whether we can come up with a plan like that and the reality is that conversation just hasn’t happened yet,” Bell said.

Bell said Leavitt has agreed to help promote discussion among legislators and those in the health care industry about expanding Medicaid, which in Kansas is called KanCare.

“He (Leavitt) would be willing to personally come into the state and sit down with policymakers and others and talk about what he sees happening in other states and talk about it from his perspective as a former HHS secretary and as a former governor,” Bell said.

The Iowa Medicaid expansion plan — which was approved earlier this month by the federal Centers for Medicare and Medicaid Services — uses federal dollars to finance the purchase of private health insurance for low income people made eligible for Medicaid under the Affordable Care Act.

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Photo courtesy Kansas Hospital Association

Tom Bell, president and CEO of the Kansas Hospital Association.

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Iowans above the poverty line — those making more than $11,490 a year — will pay a small portion of their insurance premiums. Those below the line will pay nothing. The federal government initially will cover the cost of their coverage. Over time, about 10 percent of that cost will be transferred to Iowa taxpayers in keeping with the provisions of the health reform law.

Kansas hospitals will miss out on an estimated $66 million that they would have received in 2014 had the state decided to participate in the first year of expansion, Bell said.

“Beginning in 2014 we will, in effect, be sending some of our tax dollars to states that have expanded Medicaid,” he said.

Kansas currently has some of the nation’s strictest Medicaid eligibility standards. Adults with no children are not eligible for Medicaid no matter how poor they are. Adults with children are eligible but only if they earn less than 32 percent of poverty, about $630 a month for a three-person household.

The Kansas Health Institute, the parent organization of the KHI News service, estimates that expansion would make approximately 85,300 currently uninsured Kansans eligible for Medicaid.

Gov. Sam Brownback hasn’t closed the door on Medicaid expansion, but neither has he given any indication that he is prepared to move forward with it. During an interview broadcast on Sunday by WIBW television, the governor said he was waiting to see how flexible the federal government was willing to be with states.

“I haven’t declared one way or the other because I don’t know that all the cards are out on the table,” Brownback said.

Brownback’s Democratic challenger, House Minority Leader Paul Davis recently criticized the governor for not making his position on Medicaid expansion clear to Kansas voters.

“I’m just not sure what the governor’s position is because he’s said he’s constantly undecided about this,” Davis said. “I think he needs to take a position.”

Kansas Senate President Susan Wagle could be a key to whatever negotiations take place. The Wichita Republican has indicated that she is open to considering a Medicaid expansion plan similar to those developed in Arkansas and Iowa.


Gov. Brownback interview by Melissa Brunner on WIBW-TV


KHI News Service coverage of Medicaid expansion

Medicaid Access Coalition launches online "ticker" showing foregone federal dollars (2/13/14)
→ KHI report: Nearly 182,000 Kansans in the ‘Eligibility Gap’ (1/11/14)
House speaker says Medicaid expansion is "up to the governor" (1/10/14)
KS Senate president says Medicaid expansion unlikely to gain approval this session (1/7/14)
Profiles of the coverage gap: Kathleen Christian (1/6/14)
Efforts continue to expand Medicaid in Kansas and Missouri (1/6/14)
Hospital association hires former Bush HHS secretary to help craft a plan Kansas Republicans might support (12/23/13)
Iowa wins approval to expand Medicaid by using federal funds to buy private insurance (12/11/13)
White House officials hold call to urge Medicaid expansion in Kansas (11/21/13)
Republican governor talks up plan to expand Medicaid — his way (10/28/13)
Challenger says Brownback owes voters a decision on Medicaid expansion (10/22/13)
Nearly 5.2M Americans fall in coverage gap in states not expanding Medicaid (10/16/13)
Sebelius: Feds flexible on how states expand Medicaid (9/22/13)
Sebelius says Kansas and Missouri are missing the boat on Medicaid expansion (9/20/13)
Medicaid expansion coalition finds strength in numbers (9/17/13)
Republican Gov. Corbett proposes expanding Pennsylvania Medicaid (9/16/13)
Kansas lawmakers urged to consider Medicaid expansion by Wesley CEO (8/29/13)
Estimating maneuver could help more people gain from Obamacare: How the poor might qualify for Affordable Care Act subsidies in states that don't expand Medicaid (8/12/13)
Report: States not expanding Medicaid stand to benefit most from doing so (7/18/13)
CMS won’t penalize hospitals in states slow to expand Medicaid (5/14/13)
Insurer Centene: We can do Arkansas-style Medicaid (5/14/13)
The Arkansas Medicaid Model: What you need to know about the 'private option' (5/2/13)
Nothing to be done about coverage gap in states not expanding Medicaid, feds say (4/29/13)
Brownback says he's listening to Medicaid expansion proponents, opponents (4/5/13)
Oregon shows costs of putting Medicaid enrollees in private coverage (3/29/13)
Governor urged to expand Medicaid eligibility (3/27/13)
Arkansas Medicaid expansion attracts other states' interest (3/26/13)
Senate president prefers options remain open on Medicaid expansion (3/25/13)
States urged to expand Medicaid with private insurance (3/22/13)
Senate budget amendment underscores opposition to Medicaid expansion (3/21/13)
Study: Kansas employers face millions a year in possible penalties without Medicaid expansion (3/15/13)
More than 30 Kansas groups pushing for Medicaid expansion (3/12/13)
Health insurers see big opportunities in health law’s Medicaid expansion (3/8/13)
Medicaid expansion supporters to step up lobbying efforts (3/7/13)
Budget committee hears resolution opposing Medicaid expansion (2/22/13)
Legislators focusing on Medicaid expansion cost estimates (2/19/13)
Kansas hospital group study predicts expanding Medicaid would generate 4,000 jobs (2/18/13)
Brownback officials release their cost projections for Medicaid expansion (2/8/13)
Medicaid expansion bill introduced (1/22/13)
Kansas hospitals worried about loss of dollars for charity care (1/14/13)
Brownback compiling own estimate of Medicaid expansion cost (12/20/12)
Group urges Brownback to expand Medicaid eligibility (11/9/12)
Debate begins on possible Kansas Medicaid expansion (10/25/12)
Amerigroup CEO says states ‘need’ to go along with Medicaid expansion (7/11/12)
Kansas hospitals ready to get on with federal health reform, spokesman says (7/2/12)
Kansas AG claims partial victory in health reform case (6/29/12)
High court upholds Affordable Care Act, but ruling puts limits on Medicaid expansion (6/28/12)

Commentary
→ Kansas Hospital Association: An opportunity for the Kansas Medicaid program
→ Americans for Prosperity-Kansas: Well-intentioned policies do more harm than good
→ Health Reform Resource Project: The cost of not expanding Medicaid
→ Rep. Jim Ward: Medicaid expansion essential for healthier Kansas
→ Rep. David Crum: Reasons for opposing Medicaid expansion
→ National Academy for State Health Policy: Much ado about Arkansas: Medicaid in the insurance exchange

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