KHI News Service

Challenger says Brownback owes voters a decision on Medicaid expansion

But issue not on the front burner yet for the 2014 election campaign

By Jim McLean | October 22, 2013

Democrat Paul Davis is not making Medicaid expansion a front-and-center issue in his campaign to unseat Republican Gov. Sam Brownback.

It’s an issue that could get forced onto the campaign agenda in the coming months as thousands of uninsured Kansans realize that the federal health reform law won’t help them gain medical coverage because the state’s GOP leaders have chosen against it.

Brownback and Republican legislative leaders had the opportunity earlier this year to approve the Medicaid expansion called for in the Affordable Care Act, but chose not to, citing concerns about the program’s future cost.

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State Rep. Paul Davis, a Lawrence Democrat.

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As a result, an estimated 58,000 to 85,000 low-income Kansans are expected to go without health insurance coverage in 2014 because they will remain ineligible for Medicaid but are too poor to qualify for federal subsidies to help buy private insurance through the new Obamacare marketplace.

Medical providers may also push to make expansion a campaign issue. An analysis done for the Kansas Hospital Association concluded that expanding Medicaid eligibility would inject another $3 billion into the state economy and create 4,000 jobs by 2020.

Rejecting expansion will cost Kansas an estimated $5.3 billion in federal aid between 2013 and 2022, according to a recent report by the Kaiser Family Foundation.

During the 2013 legislative session, Davis — the House minority leader, who has represented Lawrence since 2003 — criticized Brownback for not joining conservative Republican governors in New Jersey, Ohio, Florida and other states in calling for Medicaid expansion.

Those governors, said Davis, are “saying I’m going to put the people of my state above whatever political considerations are out there. And I’m disappointed that (Brownback) has decided to continue hurling the political football on this issue rather than doing what I think is the right thing for the state.”

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Jill Docking, speaking at the Topeka rally where she was introduced as Paul Davis's running mate in the 2014 gubernatorial election campaign.

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Davis didn’t mention Medicaid expansion Tuesday during a rally at a Topeka High School to introduce his running mate, Jill Docking of Wichita. But in response to a question after the event he said, “Certainly Medicaid expansion is an issue that a lot of Kansans are interested in and we’ll be talking about it during the campaign.”

Brownback, an opponent of Obamacare since his time in the U.S. Senate, has repeatedly said he is concerned about the potential costs of expansion. The reform law obligates the federal government to pay the full cost for those newly eligible for Medicaid during the first three years of Obamacare and 90 percent after that — versus the roughly 60 percent of costs the federal government currently pays. But Brownback has said he isn’t convinced that the federal government can afford to keep its funding promises.

Clay Barker, executive director of the Kansas Republican Party, spoke with reporters after the Davis campaign event. He predicted the Republican majority in the Kansas House would continue to oppose expansion.

“My sense — and I can’t speak for the governor because I’m not on his staff — is that he is against it (expansion) because he doesn’t know what the state’s future liability under it will be," Barker said. “He said he wants the Legislature to approve it and I believe the House is not going to approve it so Medicaid is not going to expand.”

Though the state won’t take part in the first year of expansion, Brownback hasn’t ruled out the possibility of participating later.

Such ambiguity isn’t fair to voters, Davis said.

“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.”<br clear="all" />

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)

→ 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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