Policy & Research


Medicaid Expansion in Kansas: Estimated Enrollment and Costs (January 2020)

Elements in Competing Versions Affect Estimated Enrollment, Costs

By Kari M. Bruffett, Phillip Steiner, M.A. | January 28, 2020

Medicaid Expansion in Kansas: Estimated Enrollment and Costs (January 2020)


Multiple proposals to expand Medicaid for low-income Kansas adults age 19-64 have emerged for consideration in the 2020 legislative session. How could selected components in some proposals, such as premiums or alternate income limits, affect enrollment and costs? This issue brief delves into the details and updates previous Kansas Health Institute estimates of the effect of expansion on KanCare.

Key points from the brief include:

  • A total of 132,000 Kansans — including 93,000 adults and 39,000 children — are estimated to newly enroll in KanCare if Medicaid is expanded.
  • This estimate differs from other estimates, including state fiscal notes, because it includes the indirect effect of expansion on children and currently eligible adults.
  • Of projected new enrollees, about 77,000 were previously uninsured, while the remaining 55,000 had other coverage and are expected to switch to KanCare.
  • The premiums included in some proposals would be expected to reduce adult enrollment by as many as 37,000 enrollees, but potentially could increase net cost to the state.
  • Total net costs to the state in 2021, after accounting for new revenues, offsetting savings and additional administrative costs, are estimated to be $15.3 million for newly eligible adults, $14.1 million for currently eligible, newly enrolled adults, and $34.4 million for newly enrolled children.
  • If these estimates approximate the actual experience, then the up to $35 million annual hospital surcharge proposed in SB 252 would more than cover the net state cost of newly enrolled adults.

*KHI also is providing detailed technical notes for those interested in further understanding the assumptions and data used to create the estimates.

The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.