Medicaid expansion

TOPEKA, Kansas — The Kansas legislative session began with what seemed like a done deal for expanding Medicaid. Gov. Laura Kelly and a top Republican senator had forged a compromise to offer health coverage for up to 130,000 low-income Kansans.

About a month later, the deal has ground to a halt — and even the state budget could be held up — because of abortion politics. 

Texas health officials are evaluating whether to accept a block grant from the Trump administration to expand the state's Medicaid program to more low-income adults.

Oklahomans will learn in the coming weeks whether Medicaid expansion supporters collected enough valid signatures to put the hotly debated question on the 2020 ballot. 

But the proposal, which could provide subsided health coverage to more than 200,000 uninsured low-income adults, likely will not be the only plan up for debate.

Public Domain via Pixabay

Health advocates in Oklahoma are continuing to press for Medicaid expansion.

As StateImpact Oklahoma reports, a U.S. Supreme Court ruling in 2012 made the expansion optional for states. After that decision, Oklahoma Gov. Mary Fallin declined federal funds that would have resulted in thousands more Oklahomans being covered by health insurance. A recent Census Bureau report found that Oklahoma has the second-highest rate of uninsured residents among all states.

The question of whether to expand Medicaid and extend health insurance to thousands of Oklahomans promises to be a major topic over the next year.

The Healthcare Working Group, a bipartisan legislative committee charged with deciding whether to endorse Medicaid expansion or other policy moves, kicked off its work last week and is expected to unveil recommendations before next year’s session. Meanwhile, a signature-collecting drive is underway to put a state question on a 2020 ballot to accept expansion.

A campaign to expand government health insurance to more low income Oklahomans overcame its first legal hurdle Tuesday.

In the waning days of the 2019 session, the conservative Republicans controlling the Kansas Legislature made one thing clear to Democratic Gov. Laura Kelly and her allies: They were ready for a fight against Medicaid expansion.  

The issue commanded the four-month session, which ended in the wee hours Sunday. The session was the first with the new Democratic governor in office, which gave people who wanted to expand health coverage for thousands of low-income Kansans the energy to push hard in the final days. Their efforts ultimately failed.

 


Supporters of expanding Medicaid in Kansas proved Wednesday they’ve got the votes in the Legislature — if they can get a vote.

But they lacked enough lawmakers on their side to bypass Republican leadership and force that vote.

The stakes run high for 130,000-some low-income Kansans who stand to gain from expanding Medicaid coverage — and for the political players who will decide the contentious issue.

Democratic Gov. Laura Kelly made expansion a centerpiece of the election that put her in office. Two Republican leaders — Senate President Susan Wagle and Senate Majority Leader Jim Denning — could see their elevation to higher office also turn on the issue.

Things were supposed to be different on the Medicaid expansion this year.

Expansion advocates thought Democratic Gov. Laura Kelly’s election would elevate the issue to center stage. They figured that would all but guarantee that Kansas would join the ranks of expansion states — now numbering 37 plus the District of Columbia.

But so far this legislative session it’s been déjà vu all over again.

Olga Kauffman is tired of the politics surrounding Medicaid.

Kauffman, a San Antonio resident who works as a health specialist with Urban Strategies, a group that builds public housing and provides services to residents, says she sees families struggle every day because of lack of access to health care and insurance.

Kansas Democratic Gov. Laura Kelly’s Medicaid expansion proposal is a retread.

It’s virtually the same bill that former Republican Gov. Sam Brownback vetoed in 2017.

An attempt to override that veto in the House failed, but only by three votes.

Jason Massingill / The Texas Tribune

More and more states have decided to expand Medicaid, but Texas has not budged. With more than a half million Texans in the so-called health coverage gap, will the politics of the issue shift in next year's legislative session?

From The Texas Tribune:

After a decade of improvement, a new study suggests the rate of uninsured children is increasing in Oklahoma.

Few issues split Kansas politics like the Obama-era expansion of Medicaid.

Unlike 33 other states, Kansas still hasn't expanded its Medicaid program under the Affordable Care Act.  The decision would pay for the health care of thousands of people who don’t currently meet the program’s stringent eligibility requirements.

Troubled Medicaid contractor Maximus could soon have a new contract with Kansas officials that pays it more to do less.

State officials say that appears to be the price of getting the job of processing applications for the privatized Medicaid program, KanCare, done right.

Texans think the Legislature should expand Medicaid to more low-income people and make health care more affordable, according to a survey released today from the Kaiser Family Foundation and the Episcopal Health Foundation.

The mere threat of launching debate on Medicaid expansion in Kansas has caged up a measure to suspend, rather than terminate, coverage for people while they’re locked up.

A push by the Brownback administration to keep turning to private firms to run its Medicaid program for years to come faces resistance from key Republican lawmakers.

Those legislators have signaled they want existing problems repaired with KanCare — particularly application backlogs, delays in provider payments and disputes over services for Kansans with disabilities. Only then should the state go ahead with Gov. Sam Brownback’s plan to launch KanCare 2.0 and its new lifetime limits, work requirements and other policy changes.

Kurykh / Wikimedia Commons

On Tuesday night, the citizens of the state of Maine voted by a wide margin to expand Medicaid coverage in the state. This vote could have repercussions in states like Texas, Oklahoma and Kansas that have refused to expand Medicaid.

As NBC News notes, Democrats “are hopeful their victories are a harbinger of further gains . . . with more ballot initiatives [and] legislative efforts to come.” Maine has tried in the past to expand Medicaid through legislative means, but the state’s Republican Governor Paul LePage vetoed five separate attempts to do so.

State Medicaid officials on Friday formally started the process of renewing KanCare, the privatized Medicaid program launched by Republican Gov. Sam Brownback in 2013.

The two state agencies that oversee the private contractors that manage the program released a draft of the plan they intend to submit for federal approval after a public comment period that runs through November.

State Medicaid officials on Friday formally started the process of renewing KanCare, the privatized Medicaid program launched by Republican Gov. Sam Brownback in 2013.

The two state agencies that oversee the private contractors that manage the program released a draft of the plan they intend to submit for federal approval after a public comment period that runs through November.

The federal agency that oversees Medicaid has agreed to a one-year extension of Kansas’ $3.2 billion KanCare program, which provides managed care services to the state’s Medicaid population.

The uninsured rates in Kansas and Missouri continue to drop, but not as fast as those in states that have expanded their Medicaid programs.

New numbers from the U.S. Census Bureau show the uninsured rate in Kansas dropped to 8.7 percent in 2016 from 9.1 percent the year before. That is not a statistically significant change.

Approximately 249,000 Kansans lacked health coverage in 2016, down from about 261,000 the previous year.

The uninsured rate in Missouri declined to 8.9 percent from 9.8 percent the previous year.

The health care plan unveiled last month by the Republican-controlled U.S. Senate met with fierce opposition from hospital, doctor and patient advocacy groups. Among them was the National Rural Health Association, which is based in Leawood, Kansas, and represents doctors, nurses and hospitals in rural areas nationwide. 

U.S. SEN. PAT ROBERTS WEBSITE

Kansas U.S. Sen. Pat Roberts is not enthusiastic about the Senate’s version of the Obamacare replacement bill.

Nevertheless, he supports it.

Three weeks after Blue Cross and Blue Shield of Kansas City said it will pull out of the Affordable Care Act exchange in 2018, Centene Corp. says it plans to offer coverage through the exchange in Missouri and Kansas.

The St. Louis-based insurer already has a presence in both states administering Medicaid plans, but the move to sell individual and small group health plans is new.

Another poll has found strong majorities of Kansans support expanding Medicaid, but some political experts say it isn’t likely to make a difference this legislative session.

The latest Medicaid expansion poll found about 68 percent of Kansans surveyed said they supported expanding the program to non-disabled adults who earn up to 138 percent of the federal poverty line, or annual income of about $16,600 for an individual and $33,400 for a family of four. About 60 percent of Republicans polled said they also supported expansion.

Republican leaders in the Kansas House say it is unlikely they will schedule another vote on Medicaid expansion in the final weeks of the legislative session.

But Democrats say they will attempt to force one.

House Majority Leader Don Hineman, a Dighton Republican, said lawmakers facing tough votes on the budget, taxes and school finance don’t want to further complicate the final weeks of the session by adding Medicaid expansion to the mix.

A third of the way to an end-of-year deadline, Kansas officials still do not have federal approval to extend KanCare.

In January, the federal Centers for Medicare and Medicaid Services denied the state’s request for a one-year extension of the waiver that allowed it to privatize its Medicaid program. The denial letter said neither the Kansas Department of Health and Environment nor the Kansas Department for Aging and Disability Services was doing enough to hold the three private companies that run the program responsible for providing services accountable to Medicaid rules.

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