Kansas, you are out of excuses. COVID relief would pay for expanding Medicaid

Again this year, Kansas Republicans have said they see Medicaid expansion as a non-starter.

But Kansas just lost its last excuse for failing to expand the program that provides health insurance for the working poor. All but 11 other states have already done so, in the 11 years since the Affordable Care Act went into effect.

Year after year, stingy state legislators have said Kansas simply can’t afford Medicaid coverage for another 165,000 residents. Too bad about the closing of rural hospitals, they said. Such a shame about poor health outcomes in urban areas. It was just too expensive, they argued.

But the recent passage of Congress’ pandemic relief package has rendered that argument moot. The bill provides more than $16 billion for states that haven’t expanded Medicaid, including Kansas, making it essentially cost-free for the next two years.

By some estimates, expanding Medicaid would cost Kansas about $200 million over two years. But the well-respected Kaiser Family Foundation recently estimated the federal government would provide $450 million to cover that cost.

That means Kansas would net an additional $250 million from Washington if it expands the program. And that doesn’t count the local economic impact of expansion, which could create thousands of additional jobs in the state, while making Kansans healthier.

Medicaid expansion helps to “reduce the uninsured, improve access to and utilization of care, reduce uncompensated care costs, improve affordability of care and reduce racial and ethnic disparities in coverage,” Kaiser said.

Kansas will lose money, and its residents will be sicker, if it fails to expand Medicaid.

Legislature rejected Gov. Laura Kelly’s proposal

Gov. Laura Kelly has pushed expansion for two years. She offered a plan this year to legalize and tax medicinal marijuana to pay for it, an effort firmly rejected by state legislators.

The federal COVID-19 relief package now gives the Legislature another chance — its best chance — to do the right thing. “The new $450 million incentive offered by the federal government is just another reason for Kansas to support this policy,” Kelly said Tuesday, “along with health care for 165,000 Kansans, thousands of new jobs, billions of dollars injected into our communities, and a lifeline for our rural hospitals.”

It’s true the additional expansion dollars expire after two years. At that point, though, the feds will still pay 90% of the cost of the expansion, which should be more than enough for Kansas to fully cover its expenses.

So cost is off the table. What might prevent Republican lawmakers from approving expansion this session?

Kansas House Majority Leader Dan Hawkins gave us a pretty good clue earlier this year, when he claimed Kelly’s expansion plan would create a state “where you can choose not to work and the taxpayers will foot the bill for you to stay home.” It was a profoundly cruel and false thing to say.

But it also shows continuing opposition to expanding Medicaid isn’t really about money. It never has been. Some lawmakers — Hawkins obviously among them — simply don’t think poor people deserve health care when they’re sick, no matter how hard they work.

“This issue has not always been about the policy, but in many cases, more about the politics,” said an email from Cindy Samuelson of the Kansas Hospital Association, which supports Medicaid expansion. She’s right.

The rest of us should recoil from the Legislature’s just-say-no attitude, including the reluctance in the House even to vote on expansion.

(Kansas Senate Majority Leader Gene Suellentrop’s recent DUI arrest should give him, and his Senate colleagues, a new reason to reconsider their opposition to needed mental health and addiction services that Medicaid expansion would provide.)

Opposition to Medicaid expansion is wrong — morally, spiritually, practically. It’s also bad politics, as voters in Missouri demonstrated last August.

The people want to help their neighbors, no matter how bitterly their elected leaders oppose that help. That opposition must end now.