Gov. Sam Brownback (R) has thwarted Kansas lawmakers rushing to expand Medicaid under Obamacare before Congress and President Donald Trump replace the Affordable Care Act (ACA).
Brownback vetoed House Bill 2044 “because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs,” according to his March 30 veto message.
The bill would have allowed up to 150,000 Kansans earning up to 138 percent of the federal poverty level, or $16,642 per person in 2017, to enroll in KanCare, the state’s Medicaid program. The Kansas Department of Health and Environment would have referred nondisabled enrollees working less than 20 hours a week to the state’s “existing workforce training programs and work search resources,” according to the bill.
Medicaid expansion had passed the Senate 25 to 14 on March 28 and the House 81 to 44 on February 23.
Under ACA, federal taxpayers pay a greatly increased federal match rate of 90–100 percent of state Medicaid expansion costs for newly eligible enrollees.
The U.S. House of Representatives is debating proposals to revise or replace ACA after House Speaker Paul Ryan (R-WI) canceled a vote on the American Health Care Act (AHCA) on March 24 due to lack of support. Under AHCA, states expanding Medicaid after March 1 would have received the pre-Obamacare federal match rate, ranging from 50 to 82 percent, for new enrollees, instead of the increased Obamacare rate.
Kansas Executive Branch Opposes
Kansas Lt. Gov. Jeff Coyler (R), a medical doctor, says increasing KanCare’s dependence on federal taxpayer funding would mean ignoring the lessons of history.
“The rest of the country is moving towards a state-driven model for improved health outcomes at a price Americans can afford,” Coyler said. “Kansas should stay the course.”
Melika Willoughby, Brownback’s communications director, says capping federal tax dollar expenditures per state Medicaid enrollee would ensure states improve their programs.
“Federal changes to Medicaid should protect the states that did not previously expand Obamacare,” Willoughby said. “The flexibility of block-granting based on a per-capita formula best allows for state-based innovation and care, and Kansas is well-positioned to lead the country in innovation.”
Expanding Medicaid could delay services for the truly needy, Willoughby says.
“Medicaid expansion moves able-bodied adults to the front of the line, ahead of truly vulnerable Kansans,” Willoughby said.
James Franko, vice president and policy director at the Kansas Policy Institute, says trusting Congress to fund Medicaid expansion indefinitely is a bad bet.
“Expanding Medicaid would saddle our state with additional fiscal challenges it can ill afford,” Franko testified to the Kansas House Health and Human Services Committee on February 9. “The persistent vulnerability of federal matching funds compounds this concern. Expansion would also fail to provide quality healthcare to many of our fellow Kansans who need it most.”
Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.
Ben Johnson, “Study: Two-Thirds of Medicaid Expansion Enrollees Were Already Eligible,” Health Care News, The Heartland Institute, January 10, 2017.
Kansas Gov. Sam Brownback (R): https://governor.kansas.gov/
Kansas Lt. Gov. Jeff Colyer (R): https://governor.kansas.gov/about-the-office/lt-governor-jeff-colyer-m-d/
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