Policy & Research


Medicaid Expansion Estimates and the Effects of COVID-19 (February 2021)

By Phillip Steiner, M.A., Kari M. Bruffett, Peter F. H. Barstad | February 10, 2021

Medicaid Expansion Estimates and the Effects of COVID-19 (February 2021)


With the passage of ballot initiatives in 2020, Missouri and Oklahoma joined Nebraska and Colorado to completely surround Kansas with states that have already expanded or will soon expand Medicaid coverage to low-income adults under the terms of the Affordable Care Act. That changing landscape, combined with a new federal administration and the lingering effects of the COVID-19 pandemic, is likely to influence debate over Medicaid expansion in Kansas in 2021.

This issue brief updates previous Kansas Health Institute estimates of the impact a potential expansion of Medicaid would have on KanCare enrollment and costs, using a methodology consistent with previous estimates. The brief also discusses potential effects of the COVID-19 pandemic on the expansion population.

Key points from the brief include:

  • Using data from before the COVID-19 pandemic, a total of 126,000 Kansans, including nearly 88,000 adults and 39,000 children, are estimated to newly enroll in KanCare if Medicaid were to be expanded in January 2022.
  • While the estimated new enrollment represents an increase of approximately 31 percent from recent KanCare enrollment, expansion would be estimated to increase total state KanCare spending by just 2.7 percent per year on average over a 10-year period, compared to projections based on the pre-pandemic trend.
  • The estimate differs from state fiscal notes and other estimates because it includes the indirect effect of expansion on enrollment of children and currently eligible adults.
  • COVID-19 has increased Medicaid enrollment in all states, including those states that have not expanded Medicaid, as federal pandemic relief encouraged states to adopt administrative policies to prevent current beneficiaries from being disenrolled.
  • The effects of COVID-19 on expansion enrollment beginning in January 2022 are difficult to project, but if the economic effects of the pandemic persist, Medicaid expansion would offer an option for insurance coverage for those who remain unemployed.

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

Click here for a list of other KHI publications on Medicaid Expansion. 

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.