KHI News Service

White House officials hold call to urge Medicaid expansion in Kansas

Gov. Brownback likens Medicaid expansion to Obama's pledge: "If you like your plan, you can keep it"

By Phil Cauthon | November 21, 2013

White House officials today held a news conference with Kansas State Rep. Barbara Ballard to make the case for expanding Medicaid eligibility in Kansas.

White House Principal Deputy Press Secretary Josh Earnest said the health reform law will make access to health insurance coverage available for less than $100 a month to six in 10 currently uninsured Americans.

If the 24 states, including Kansas, that have so far refused to expand Medicaid were to change their stances, that number would be eight in 10, he said.

"The 24 states that have blocked Medicaid expansion face a consequential choice: They can score short-term political points by attacking the Affordable Care Act and blocking Medicaid," Earnest said. "Or they can take action to save taxpayer dollars and extend access to thousands of citizens to quality affordable health care. For those politicians with the courage to put the interests of their state and their citizens ahead of politics, it shouldn't be a tough choice."

Ballard — who joined the teleconference from Kansas — said opposition to Obamacare was not a legitimate reason to oppose Medicaid expansion.

Rep. Barbara Ballard (D-Lawrence).

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"Why don't we want to cover these people?" said Ballard, a Lawrence Democrat. "We all know how important insurance is. We all sleep better at night if we have insurance."

Why not?

Gov. Sam Brownback — a Republican opponent of Obamacare since his time in the U.S. Senate — has repeatedly said he is concerned about the potential costs of opening the program to more people. Kansas currently has some of the nation's strictest eligibility standards.

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 as its share of Medicaid. States shoulder the balance of the cost.

But Brownback has repeatedly said he is unconvinced that the federal government can afford to keep its funding promises.

"The governor believes 'If you expand Medicaid, we'll pay for almost all of it forever,' sounds way too much like 'If you like your insurance plan, you can keep it,'" Brownback spokesperson Sara Belfry wrote in an email to KHI News Service today, referring to the recent outcry over the president's unraveling campaign pledge.

Ballard said she was familiar with the governor's argument against expansion, but called it "a convenient excuse."

"That does not negate the fact that people still need Medicaid expansion in order to be insured," Ballard said.

Ambiguous position

Kansas 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 costs.

As a result, an estimated 58,000 to 78,000 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 insurance marketplace.

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, said Brownback's likely challenger in the 2014 election, Paul Davis.

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

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.

New Jersey Gov. Chris Christie says he supports expanding Medicaid under Obamacare, joining other Republican governors who have been staunch opponents of the health reform law.

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Republican governors in several states have signaled they support expanding Medicaid, including those in Ohio, New Jersey, Florida, and Pennsylvania.

Several Republican governors have said they plan to do so using the so-called "Arkansas model," which entails using Medicaid expansion funds to help pay for private insurance coverage.

That model was charted by Arkansas Medicaid director Andy Allison, who was previously Kansas' Medicaid director and a senior analyst at the Kansas Health Institute.

The federal government has said it is receptive to states seeking to employ the Arkansas model, and some Republican leaders in Kansas — including Senate President Susan Wagle (R-Wichita) — have suggested they are open to the idea.

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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