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Republican senator clashes with Brownback on Medicaid expansion

Sen. Jeff King says private-sector expansion plan could help fix health care system that’s failing ‘hard-working Kansans’

By Jim McLean | October 23, 2015

Republican senator clashes with Brownback on Medicaid expansion
Photo by KHI News Service Kansas Senate Vice President Jeff King, a Republican from Independence, is taking issue with Gov. Sam Brownback’s reasons for opposing Medicaid expansion.

Kansas Senate Vice President Jeff King is taking issue with Gov. Sam Brownback’s reasons for opposing Medicaid expansion.

Melika Willoughby, Brownback’s deputy communications director, outlined those reasons in an Oct. 6 email to supporters. Referring to expansion as a “masquerading component of Obamacare,” Willoughby said the governor believes it would be “morally reprehensible” for the state to provide health coverage to low-income Kansans “who choose not to work” before providing support services to all of the disabled Kansans now on waiting lists.

In addition, Willoughby accused expansion supporters of “lying” by claiming the additional federal funding that expansion would have generated might have prevented the closure earlier this month of Mercy Hospital in King’s hometown of Independence.

In a response posted Thursday on his website, King pushed back. He said contrary to Willoughby’s assertion the “vast majority” of uninsured Kansans who would be eligible for coverage under expansion are “working adults and students.”

“I refuse to make moral judgments based on a person’s view of Medicaid expansion. I wish Ms. Willoughby would have done the same,” King wrote. “Maybe if her hospital was closing. Maybe if her parents were wondering where to go for emergency care. Maybe if she faced uncertainty in her health care future, she would view those looking for health care answers in a little less judgmental light.”

King, a self-described conservative Republican and former expansion opponent, now supports the kind of private-sector approach being taken in other Republican-controlled states.

“We are looking at using federal funds to help small businesses provide private health insurance for their employees and assist colleges in getting private insurance for their students,” King wrote. “Conservative states like Indiana have shown that this can work. Far from expanding ‘government-run health care,’ the Indiana model and those like it expand private health care, limiting the role of government.”

Indiana’s expansion plan, approved by federal officials in January, uses Medicaid dollars to purchase high-deductible health insurance plans for adults making up to 100 percent of the federal poverty level, annually $11,770 for individuals and $24,250 for a family of four. The state then contributes money to a Personal Wellness and Responsibility, or POWER, account that beneficiaries can use to cover out-of-pocket costs. The Indiana plan also requires beneficiaries to contribute to the account.

Forum to focus on Indiana plan

The Indiana expansion plan will be the focus of a Nov. 3 forum in Wichita sponsored by several Kansas hospitals and health foundations. Doug Leonard, president of the Indiana Hospital Association, and Jonathan Nalli, chief executive of St. Vincent hospital in Indianapolis, will participate in a panel discussion about the Indiana expansion plan.

A second panel discussion will feature King and three other Kansas legislators: Sen. Michael O’Donnell, a Wichita Republican, Rep. Dan Hawkins, a Wichita Republican who serves as chairman of the House Health and Human Services Committee, and the ranking Democrat on the committee, Rep. Jim Ward, also from Wichita.

Jeff Korsmo, CEO of Via Christi Health, one of the sponsoring hospitals, said organizers would like to create some momentum on the expansion issue heading into the 2016 legislative session.

“Our hope is that it’s a series of conversations that can lead to some productive sharing of information and maybe start generating some answers that can move us forward,” Korsmo said.

King appears ready to help lead that discussion.  

“Our health care system failed Independence and it is failing tens of thousands of hard-working Kansans,” King said in the column posted to his website. “I don’t have all the answers, but saying no to everything isn’t an option.”

But other Republican leaders remain opposed. A talking-points memo they recently commissioned to sharpen their arguments says that costs have far exceeded estimates in many expansion states. It also asserts that the low-income adults who would gain coverage under expansion are capable of taking care of themselves.

“Our health care system failed Independence and it is failing tens of thousands of hard-working Kansans. I don’t have all the answers, but saying no to everything isn’t an option.”

- Kansas Senate Vice President Jeff King, a Republican from Independence

“The population Medicaid expansion would cover consists of healthy adults without children who could receive private coverage if they work 33 hours a week at the minimum wage,” the memo says, referring to the income level at which people can qualify for federal tax credits to help them purchase coverage on the Affordable Care Act marketplace.

KanCare eligibility limits

Brownback privatized the Kansas Medicaid program in 2013. Now called KanCare, the nearly $3 billion program is administered by three managed care organizations.

KanCare now covers about 425,000 low-income children and families, plus disabled and low-income elderly adults. Adults with dependent children are eligible for KanCare coverage only if they have incomes below 33 percent of the federal poverty level, annually $7,870 for a family of four. Non-disabled adults without children aren’t eligible regardless of income.

Expansion would extend KanCare coverage to non-disabled, childless adults with incomes up to 138 percent of poverty: annually $16,105 for an individual and $32,913 for a family of four. 

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