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Analysis: Kansas, Missouri Uninsured Rates Would Jump Under Senate Health Care Bill

Urban Institute

Kansas’ uninsured rate would be 35 percent higher by 2022 under the Senate’s health care proposal than under the Affordable Care Act, according to an analysis by the Urban Institute.

Missouri’s would be 50 percent higher, according to the analysis, which shows how states would be affected by the Better Care Reconciliation Act, the GOP bill that would overturn large chunks of the Affordable Care Act (ACA). 

Currently, the number of uninsured Kansas adults and children stands at 343,000. That number would jump to 463,000 in five years, the analysis by the Urban Institute, a left-leaning think tank, finds.

Similarly, the number of uninsured Missouri adults and children would rise from 596,000 to 894,000 in 2022.

“They’re still trying to cut taxes, and on the backs of unhealthy, poor Americans,” says former Kansas Insurance Commissioner Sandy Praeger, who was elected as a Republican. “They’re the ones who are going to feel the brunt of this.”

Because Kansas and Missouri were among 19 states that opted not to expand Medicaid under the ACA, the GOP proposal won’t affect insurance rates in those two states as drastically as in states that did expand Medicaid eligibility, according to the analysis.

Nonetheless, the analysis finds that Missouri will see its share of Medicaid and Children’s Health Insurance Program enrollees fall by 7.8 percent under the GOP plan and Kansas’ share shrink by 1 percent.

“Our people in Kansas continue to suffer when people in other states didn’t because they expanded Medicaid,” Praeger says. “Now those other states go back to the way we’ve been all along, which was not doing the Medicaid expansion.”

Sheldon Weisgrau, director of the Health Reform Resource Project in Kansas, notes that Kansas historically had relatively low uninsured rates compared to other states. But because Kansas did not expand Medicaid, that’s no longer the case. 

“If this (Senate) bill is passed,” he says, “we would look relatively good compared to the rest of the country. But I don’t think that's a reasonable measure. I mean, we’re going backward from where we are today.” 

The Urban Institute concludes that the number of uninsured people would increase in every state under the Senate bill.

Compared to the ACA, it says 24.7 million fewer nonelderly Americans would have insurance by 2022. That’s more than the estimate of the nonpartisan Congressional Budget Office, which says the bill would leave 22 million fewer Americans with health insurance by 2026.

Accounting for about a third of the Urban Institute’s figure, about 7.9 million fewer Americans will have private nongroup coverage under the Senate bill. In Kansas, that translates into 68,000 fewer people with nongroup coverage, a 38.7 percent drop. In Missouri, that means 130,000 fewer people with nongroup coverage, a 36 percent drop.

"Anything they come up with, we're going to see millions of people losing insurance and we're going to see Medicaid being devastated," says Weisgrau. "We might see some changes that put more support in the (ACA) marketplace for low-income people, but the bottom line at the end of the day is that a lot of people are going to lose insurance, and the Medicaid program is going to be forever changed." 

U.S. Sen. Jerry Moran, a Kansas Republican, is one of a handful of GOP senators who are undecided on the Senate bill. His fellow GOP senator, Pat Roberts, says he supports it.

In Missouri, Democratic Sen. Claire McCaskill, like all of her fellow Democrats, opposes the bill. Republican Sen. Roy Blunt says he supports it. 

Senate Majority Leader Mitch McConnell, a Kentucky Republican, delayed a vote on the measure before the July 4 recess, when it became apparent it did not have enough votes to pass. The Senate returned from its recess Monday and is expected to vote on some version of the bill before August.

Dan Margolies is KCUR’s health editor. You can reach him on Twitter @DanMargolies.

Dan Margolies has been a reporter for the Kansas City Business Journal, The Kansas City Star, and KCUR Public Radio. He retired as a reporter in December 2022 after a 37-year journalism career.
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