Compassion demands KanCare expansion

Last week, the Kansas Legislature passed the Medicaid expansion bill. Medicaid in Kansas is known as KanCare, and has been managed by the Brownback administration since the advent of the Affordable Care Act. Patients, doctors, hospitals, and insurance companies have all complained. One surefire way to improve things would be to take advantage of the ACA's provision for expansion of Medicaid coverage. But Governor Brownback and a few stalwart allies in the Legislature have refused, turning down billions of dollars in Federal funding.

Predictably, Governor Brownback vetoed the expansion of KanCare last week. Over the weekend, advocates for patients, doctors, and hospitals have been asking, begging, and pleading with those recalcitrant Kansas lawmakers to change their votes, to overturn Brownback's veto.

We will see this week, if that happens.

(Of course, given that Friday, April 7 is the end the Legislature's general session (to be followed by the veto session and likely extra sessions), lots of bills will be getting attention this week, including school finance, the recission bill, the two-year budget bill, and tax reform. We covered the budget issue and school finance in recent Updates, if you want to catch up.)

What are the facts of KanCare expansion?

What if the Feds repeal Obamacare? The Affordable Care Act is here to stay. Even with sweeping control of government—the House, the Senate, and the Presidency—right wing conservatives were unable to take health care away from 20 million Americans. That means adding 150,000 Kansans to Medicaid is not only compassionate, but sustainable, too.

Who will expansion help? The number cited is 150,000 Kansans who will receive health care coverage. Who are these people? These are working Kansas adults. They are caught in the coverage gap created when the Supreme Court ruled Medicaid expansion optional. They make too much money to qualify for subsidies under unexpanded KanCare, but they do not qualify for employer-provided care, and cannot afford private insurance. They are parents, veterans, and neighbors.

Who else will expansion help? 150,000 more people with health coverage means demand for more health care jobs. Studies show as many as 3,800 well-paying health care jobs would be created in Kansas. That improves our local economies. It keeps rural hospitals—and the communities they serve—intact. And that many more people in the system improves insurance costs for all of us.

Who will expansion hurt? Besides the egos of Governor Brownback, Lt. Gov. Colyer, and their allies and patrons? Well, here is the crux of the matter. The Federal program pays for the bulk of expansion, but yes, there is a cost to Kansas for expansion. But that cost will be offset by improvements to the economy, improvements Gov. Brownback's 2012 tax plan has failed to produce. Former Kansas legislator, chair of the budget committee, and Senate President Dave Kerr (R) has testified that in the first year of expansion, a surplus of as much as $70 million would come to Kansas. The Governor's numbers do not include any of the economic benefits of expansion, only the cost. Budgeting is hard when you only include what you spend, and not what you make.

But let us ask you, even if there were a cost to Kansans, is that not a cost we would be willing to bear? When the right wing conservatives call for "efficiencies" or leaving heath care "to free market forces," what they really mean is that we should run health care like a business. In business, there are always acceptable losses. You can never reach 100% efficiency. There's always something that comes off the bottom line. Just the cost of doing business. But when you're talking about health care, those acceptable losses are people. That is unacceptable to us, and should be to every Kansan. We are all one misfortune away from needing this safety net, but even without that self interest, our compassion should require that we expand health care to everyone who needs it.

82% of Kansas are in favor of expansion. The Legislature passed expansion 106-58. Compassion demands it.

If you have not done so yet, read up on expansion with our partner, the Alliance for a Healthy Kansas, and contact your legislators.

Remember to do more than vote. Get informed. Get involved. Make a difference.

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