Supporters of expanding Kansas Medicaid eligibility to more low-income adults rallied Friday at the Statehouse to call attention to the issue as legislators formally ended the 2014 session.
The federal health reform law initially required states to expand Medicaid eligibility. But the U.S. Supreme Court decision in June 2012 that upheld the law made expansion optional for states.
Twenty-six states and the District of Columbia have or are in the process of expanding their programs, according to the nonpartisan Kaiser Family Foundation. Kansas is among 19 states that have rejected expansion. The issue remains alive in the remaining five.
“They’re gone until January,” said Sean Gatewood, director of the Medicaid Access Coalition, after the Legislature formally adjourned its 2014 session. “I think it’s a shame that this issue hasn’t been taken up.”
Gatewood, a former Democratic legislator from Topeka, said the rally was staged to signal to lawmakers that coalition members would be back at the Capitol demanding action when the 2015 session convenes in January.
“I know it takes a while to pass legislation,” he said. “This isn’t my first rodeo.”
A crowd of between 40 and 50 turned out for the event held on the south steps of the Statehouse to hear Gatewood, Rep. Jim Ward, a Wichita Democrat, and Joshua Longbottom, pastor of the Central Congregational Church in Topeka.
Longbottom said elected officials take God’s name in vain when they stress their strong religious beliefs while campaigning and then oppose programs to help the poor.
“It means that you can’t pass policies that rob the poor at the same time as you pad your poll numbers by claiming to be a follower of Christ,” Longbottom said.
“It means that you can’t sit idly by for partisan commitments while the most vulnerable suffer illness and disease and have no recourse for proper medical attention.”
Currently, most of the roughly 380,000 Kansans enrolled in Medicaid – called KanCare – are children, new mothers, the disabled and seniors in nursing homes. Able-bodied adults with children are eligible only if they earn less than 33 percent of the federal poverty level (FPL), which for a family of four is $7,770. No matter their income, Kansas adults without children aren’t eligible unless they are disabled.
Expansion would extend Medicaid coverage to all those earning less than 138 percent of FPL – about $32,500 for a family of four.
In addition, nearly 80,000 uninsured Kansans are expected to fall into what is being called the “Medicaid gap,” because in addition to being ineligible for Medicaid they earn too little to qualify for federal subsidies to help them purchase private health insurance.
Ward introduced a Medicaid expansion bill, but he said Republican leaders refused to allow a hearing on it.
“That is wrong,” he said. “This is the place where we have those discussions. This is the place where you get to hold us accountable … and to deny that is wrong.”
Many expect the conversation to change once the 2014 elections are over. Brownback, for one, said he is open to discussing next year a more private-sector approach to expansion similar to those being attempted in Arkansas, Pennsylvania, Iowa and a handful of other states. Those states are using federal Medicaid dollars to purchase private coverage for individuals with incomes between 100 percent and 138 percent of poverty.
“We’re watching all of it,” Brownback said. “I am more confident today than I’ve ever been there will be other options out there.”
Jim McLean is executive editor of KHI News Service, an editorially independent reporting program of the Kansas Health Institute.