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Originally published Feb. 8, 2013 at 3:15 p.m., updated Feb. 14, 2013 at 2:51 p.m.
TOPEKA The administration of Gov. Sam Brownback today released a summary of its estimated cost for Kansas to expand the Medicaid program.
More details on how the projection were made are promised for release next week, but officials said the state could expect to spend an additional $513 million over 10 years, if it does nothing different or $1.1 billion over the same period if policymakers choose to open Medicaid to people earning up to 138 percent of federal poverty guidelines.
Currently, Kansas has among the nation's most restrictive eligibility standards, limiting Medicaid coverage to poor children, pregnant women, the disabled and elderly. Childless adults are excluded regardless how little income they have.
Brownback officials said the cost estimates were prepared by the consulting firm Aon Hewitt. The projected cost, according to their findings, would be significantly less than some previous estimates but considerably more than others.
“We look forward to working with the State Legislature in the coming weeks to discuss the findings as the members deliberate the impact of expansion,” said KDHE secretary Dr. Robert Moser in a prepared statement.
Unlike some conservative GOP governors, Brownback has not yet said whether he would support expanding Medicaid.
But it is already clear that key Republicans in the Legislature would fight opening up the program, a move that is supported by many in the Kansas health industry, including the Kansas Hospital Association. The federal government, when it passed the Affordable Care Act in 2010, pledged to cover most of the cost of covering new Medicaid enrollees, once that portion of the law kicks in on Jan. 1, 2014. But many of the law's opponents say they doubt Washington can keep the pledge given the size of the federal deficit.
House Speaker Ray Merrick, a Stilwell Republican, told KHI News Service that he wouldn't support Medicaid expansion regardless the cost estimate.
"I don't believe any number we get is going to be a number that's cast in concrete," he said. "Where is the federal government going to get the money — other than borrowing it from the Chinese — to do what they say they're going to do. And we take the bait and we're sitting here two years from now counting the change saying, 'why did we do this?' Fool me once, fool me twice...I'm not really willing to go there again."
Brownback hasn't yet ruled out the possibility he would support an expansion, but comments from administration officials have led many to assume that is unlikely.
“For Kansas to expand the Medicaid program as the (Affordable Care Act) requires, the state would need more than $1 billion in new expenditures," said Sherriene Jones-Sontag, the governor's chief spokesperson. "This impact would be significant and would directly affect the ability of the state to fund other core responsibilities like K-12 education and public safety. And if the federal government fails to keep its promise to pay for its part of the expansion, the direct impact would be even greater."
Even before the Brownback administration projections, the Legislature's research arm already had noted 10 varying estimates of what the costs could be.
The reports are not easily compared — they vary, for example, in the timeframe of their estimates and the number of people projected to gain coverage — but roughly they range from a high of $2.1 billion to a low of about $171 million over six years. The Kansas Policy Institute, a conservative think tank based in Wichita, arrived at the high number. The Kansas Health Institute had the low estimate in that bunch but prepared three different scenarios with the most expensive coming in at about $750 million.
The defunct Kansas Health Policy Authority commissioned the first Kansas-specific cost projections. The actuarial firm of schramm-raleigh concluded the Medicaid expansion could cost the state as much as $35 million more a year or save it up to $39 million a year, depending how policymakers chose to implement the expansion.
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