Supporters of Medicaid expansion are kicking off a campaign to mobilize Kansas voters on the issue.
Federal tax rules prohibit the nonprofit Alliance for a Healthy Kansas from engaging in direct political activity, so the group is mounting a vigorous educational campaign through a series of community meetings across the state.
The goal is to educate Kansans about the economic and health benefits of expanding eligibility for KanCare, the state’s privatized Medicaid program, so that they can question incumbent lawmakers and challengers about the issue during the primary and general election campaigns, said David Jordan, executive director of the alliance.
“These aren’t political events, they are events to engage community members and community leaders,” said Jordan, noting that Kansas has so far lost out on more than $1.2 billion in additional federal Medicaid funds.
The alliance, which boasts more than 70 member organizations, kicked off the series Tuesday in Wichita and has meetings scheduled Wednesday in Dodge City and Thursday in Garden City. Meetings scheduled through mid-July include sessions in Topeka, Overland Park, Independence and Hutchinson.
“We expect to hold over two dozen meetings between now and November,” Jordan said.
Carl Shay, one of two Democrats vying for the right to challenge Republican Sen. Forrest Knox, an expansion opponent, in the November general election attended the Wichita meeting and made it clear in a Facebook post where he stands on the issue.
"Kansans already pay for this and aren't allowed to use it for purely political reasons," Shay wrote. "Kansans shouldn't have to choose between eating and being healthy."
Shay, a member of the Fredonia Unified School District Board of Education, is running against Mark Pringle, Yates Center, for the Democratic nomination. Knox is being challenged by Bruce Givens, El Dorado, in the GOP primary.
Forcing a discussion
There has been relatively little discussion of Medicaid expansion at the Statehouse since it became an option for states almost three years ago as part of the federal Affordable Care Act. Gov. Sam Brownback and Republican legislative leaders have blocked consideration of the issue despite polls conducted by the Kansas Hospital Association and others that show a majority of Kansans support it.
But expansion advocates see this year’s election as an opportunity to force the issue. Polls indicate a majority of Kansas voters are dissatisfied with Brownback and the Legislature because of their inability to solve ongoing budget problems that have forced them to cut spending on highways, higher education, KanCare and other social programs.
“The will of the people has been overlooked on the issue of expanding KanCare,” Jordan said. “Now, it’s incumbent upon us as Kansans who want the best for our state to make sure that policymakers and candidates understand that and see the energy for this issue in their communities.”
In addition to the community meetings, Jordan said the alliance will launch a petition drive once lawmakers conclude their special session on school finance. Online signatures will automatically trigger targeted emails to incumbent legislators and candidates.
Several health foundations are members of the alliance, including the Kansas Health Foundation, which is the primary funder of the Kansas Health Institute, the parent organization of the editorially independent KHI News Service.
Cost and fairness issues
Brownback and other expansion opponents say the state can’t afford the additional cost of Medicaid expansion even though the federal government will shoulder all but 10 percent of the cost and studies by the hospital association indicate that expansion would pay for itself.
Opponents also object to expanding KanCare coverage to non-disabled adults at a time when many Kansans with physical and developmental disabilities are on waiting lists for support services.
Last fall, Melika Willoughby, Brownback’s deputy communications director, detailed the governor’s opposition to expansion in an email to supporters. She wrote that 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.
Since the start of 2014, when the main provisions of the Affordable Care Act took effect, 31 states and the District of Columbia have expanded Medicaid eligibility to all adults earning up to 138 percent of the federal poverty level, according to the Kaiser Family Foundation. Kansas is among 19 states that have rejected expansion.
The annual income limits in expansion states are $16,242 for an individual and $33,465 for a family of four. In Kansas, only adults with dependent children are eligible for KanCare, the state’s privatized Medicaid program, and then only if their annual incomes are below 28 percent of the poverty level, which for a family of four is $9,216.
Expansion would provide coverage to approximately 150,000 Kansans, many but not all of whom are now uninsured, and generate additional federal dollars for providers hit hard by reductions in Medicare reimbursements triggered by the health reform law and a budget-cutting formula that congressional conservatives demanded.