Everybody does this sometimes. We decide by not making a decision.
By BARBARA SHELLY
The Kansas City Star
So it seems to be with Kansas Gov. Sam Brownback and Medicaid expansion. For months Brownback has been mysterious about whether hell be one of the Republican governors who want to insure more low-income people, or stay on the sidelines with governors like his pal, Rick Perry of Texas.
Brownback still hasnt said one way or the other. But its getting late in the session to convince a reluctant Legislature to accept an expansion and add the federal Medicaid funds to the budget. Without a formal declaration, Id say the issue is dead for this year, as it is in Missouri.
One of the things Brownback has worried aloud about is his fear that the federal government will back off on its commitment to the states to fund all of the costs of their Medicaid expansions for three years, and never less than 90 percent after that. Brownback doesnt want Kansas to have to pick up the slack.
Personally, I think GOP worries about Washington reneging on paying for Medicaid expansion are exaggerated. Congress inclination has always been to expand, not contract, Medicaid eligibility.
But Brownbacks worries about federal money and Medicaid make his request this week for additional bonding authority for the huge biolab project slated for Kansas State University all the more perplexing.
The governor asked the Legislature to allow the issuance of an additional $200 million in bonds, on top of $105 million already authorized. The federal government is broke, he told a KCUR radio reporter. If we dont step up with some more in the cost share, my fear is we dont get the project done.
Brownback is consistent on his insistence that Washington is broke. But if thats the case, isnt he worried the state might be asked to take on even more of the cost of the National Bio- and Agro-Defense Facility, which right now is projected at $1.15 billion? And what about ongoing operating expenses? NBAF would be run as a Homeland Security project, but if youre really worried about a bankrupt federal government, a scenario whereby the state is asked to pick up a share isnt unimaginable.
The key is, Brownback really wants the NBAF facility to be built. It is expected to create about 750 construction jobs and more than 300 good-paying jobs when completed, and have a roaring economic impact during construction and afterward.
Then again, a study for the Kansas Hospital Association concluded that a Medicaid expansion would create 3,500 to 4,000 new jobs, most of them in health care but some reflecting a multiplier effect in other fields.
The thinking of Gov. Brownback is mysterious indeed. But I think we can say with some certainty that a pathogen lab is more attractive to him as an economic stimulus than an expansion of health care to low-income Kansans.