A continuing health care controversy in Kansas is whether or not to expand KanCare. Here we summarize the issue and where we stand today.
One of the legacies left to us by former president Barack Obama was a medical insurance program frequently called “Obamacare” (actual name — the Affordable Care Act). Although the U. S. Supreme Court made the program weaker than intended, it did set two precedents in medical health care. The first was that no one could be denied coverage based on preexisting conditions, and the second was that a dependent child could stay on the parents’ policy until he or she reaches the age of 24.
Another legacy is the expansion of Medicaid, which continues to be an issue in Kansas. First, let us be sure that we understand Medicaid. The statistics that follow are taken from the Alliance for a Healthy Kansas (www.expandkancare.com).
Medicaid is a state and federal health program, largely managed by the state and provides health insurance to low-income families who meet certain criteria. In Kansas, 55 percent of the funding is from the federal government, and 45 percent is from the state. While different states have different requirements, the program in Kansas is called “KanCare” and is administrated by companies under contract with the state.
States have different regulations, and Kansas is one of the most restrictive of all. KanCare covers families and children, pregnant women, the elderly, and people with disabilities. Non-disabled adults without children are not eligible. Although it varies with the size of the family, a family of three must have an income of less than $675 per month. To understand how much that is, the Alliance for a Healthy Kansas states that a single mother with two children who works a minimum wage job for 22 hours per week, would make too much to be eligible for KanCare. Currently, about 400,000 Kansans are covered by KanCare.
What about those who make too much to qualify, but not enough to pay for quality insurance? Since 2014 states have had the option of expanding Medicaid. This expansion is jointly funded by the state and federal government, with the feds paying 90 percent and the state 10 percent. Under expanded Medicaid, a family of three with monthly income of less than $2,450 would qualify.
The Alliance for a Healthy Kansas estimates that approximately 150,000 Kansans would be eligible, and their participation would significantly benefit the state. Approximately $700 million federal tax dollars would return to the state annually, bringing an estimated 3,800 new jobs. Not participating since the onset of the program has cost the state an estimated $4 billion to date.
Expanded KanCare, had we enrolled, would have brought the state good health, growth of jobs, and federal dollars. Why are we not enrolled?
In January of this year, the Kansas Legislature introduced a constitutional amendment stating that there is no right to abortion or public funding for abortions in the Kansas Constitution. That amendment easily passed in the Senate by the required two-thirds majority but failed in the House by a few votes. That amendment became a barrier in passing KanCare expansion.
Some House members opposed to the proposed amendment indicated that their opposition was based on the clause specifying the issue was to be voted upon by the public during the August election, which is essentially a Republican primary. An amendment was added in the Senate to change the public vote to the November general election, but the amendment was defeated by a vote of 27-13. What went forward was a bill that probably would have passed in both houses regardless of the date of the public election had legislators in both houses been able to vote.
How did this affect the move to expand KanCare? When Governor Kelly was running for office, she made it clear that her primary campaign promise was to make KanCare expansion available to Kansans. But at the same time, the president of the Senate, Susan Wagle, was mounting a major effort to pass the constitutional amendment that would undo the Supreme Court decision which allows women the right to have an abortion in Kansas.
During Governor Kelly’s first legislative session, KanCare expansion passed easily in the House, and moved on to the Senate. Polls indicated that enough senators were in favor to move the bill along to the governor; however, Senate President Wagle, who has total control of what goes to the floor of the Senate, held the bill hostage, basically saying to the governor, “You give me what I want on abortion, and I will give you what you want on KanCare expansion.” And there we stand.
There is, however, hope for the future. When the 2021 legislative session convenes, there will be many new faces in both houses, and there will be a new Senate President, since Susan Wagle has already announced her retirement.
When you go to the polls for the primary election in August and the general election in November, we urge you to know where the candidates stand on KanCare expansion, and to vote to expand KanCare.