Not all Medicaid expansion plans are equal, a Kansas healthcare advocate told Iolans Tuesday evening.
States like Kansas that havent yet expanded Medicaid often add requirements that can make it more difficult to apply or receive coverage, Sheldon Weisgrau, senior policy adviser for the Alliance for a Healthy Kansas, said. He spoke to a group of about 20 local healthcare and political advocates as part of the Break Down and Bounce Back tour that visited Iola Tuesday.
Many states have taken advantage of provisions in the Affordable Care Act that expand Medicaid to adults who earn up to 138% of the federal poverty level, with the federal government covering 90 percent of the cost to states. But some states, particularly those under Republican leadership, say states cant afford other associated costs and worry states will be left with an unfair burden if the federal rules and funding changes.
The Alliance representatives recapped the previous legislative session, when Kansas lawmakers came close to expanding the KanCare Medicaid program but ultimately fell short. They also talked about proposals that could come in the next session, thanked local advocates for their work and encouraged them to continue.
Examples of add-on programs that restrict Medicaid expansion include work requirements, drug testing and cost sharing programs. On the surface, those things sound good but place extra burdens on low-income Kansans who already face significant barriers to affordable healthcare, Weisgrau said. The programs typically add administrative costs to the state and cover fewer people, he said.
Work requirements and drug testing tend to deter enrollment or cause people to be dropped because of the bureaucratic red tape associated with proving and tracking those things, Wesigrau said. Many of those who are dropped or unable to enroll actually meet the requirements but arent able to wade through the paperwork, Weisgrau said.
Cost sharing programs, which require participants to pay a fee or part of the cost of coverage, unfairly burden the lowest income families, Weisgrau said. Thats also true with requirements that charge participants for missing appointments, he said.
But other programs can help low-income families, he said. Some policymakers have suggested adding things like a premium support program. Under that program, the state would help low-income Kansas pay for health insurance premiums offered through their employers. That would reduce the number of those who would otherwise qualify for the governments healthcare program, but still provide coverage.
We know we have to compromise but we have to look very carefully at what those compromises mean, Weisgrau said. You may hear the Alliance is not supporting a particular expansion bill. Thats because we want to make sure it will work for the people of Kansas.
