Medicaid expansion would help bottom line



January 9, 2014 - 12:00 AM

Dick Works encouraged legislators who will represent Allen County in the Kansas House to take “a hard look” at the state’s refusal to accept Medicaid support from the federal government.
“We’re losing supplemental income,” at the new Allen County Regional Hospital with rejection of the federal revenue, “as well as expansion” of that revenue source, County Counselor Alan Weber said at Tuesday morning’s commission meeting. He estimated ACRH might lose as much as $500,000 a year “from its bottom line.”
The legislators are Kent Thompson, Republican who will represent most of Allen County, and Adam Lusker, Frontenac Democrat, who will represent the eastern tier of the county. Both are filling unexpired terms and will stand for re-election in November.
At Gov. Sam Brownback’s insistence, Kansas rejected the federal government’s offer to pay 100 percent of an Medicaid program for three years and 90 percent beyond that.
Brownback’s rationale was his fear the federal government would renege on Medicaid funding and leave Kansas with the responsibility. In addition to Kansas, 23 other Republican-dominated states turned down the federal assistance.

AN ANALYSIS written by Jim McLean of the editorially independent Kansas Health Institute New Service, pointed out many uninsured Kansans who Congress assumed would get coverage under the  health reform law instead were falling into what is being called the “Medicaid gap.”
They make too much money or don’t meet other criteria to qualify for the state’s Medicaid program — KanCare — but don’t earn enough to be eligible for federal tax credits to offset the cost of private insurance through the Affordable Care Act.
Those credits are available only to people with incomes between 100 percent and 400 percent of federal poverty guidelines, $11,490 a year for an individual, $19,530 for a family of three. As many as 85,000 uninsured Kansans fall in the eligibility gap, according to KHI.
These Kansans have incomes of 33 percent or more of the federal poverty threshold — $6,445 for a family of three — but below 100 percent of poverty guidelines.
The ACA was written in 2010 to include a nationwide expansion of Medicaid to cover those earning up to 133 percent of the federal poverty level — $15,282 for an individual and $25,975 for a family of three. But a 2012 U.S. Supreme Court decision that upheld the law noted Medicaid expansion was an option for each state.
An analysis done for the Kansas Hospital Association concluded that expanding Medicaid eligibility starting this year would have injected another $3 billion into the Kansas economy and create 4,000 jobs by 2020.
Rejecting expansion will cost Kansas an estimated $5.3 billion in federal aid through 2022, according to a report by the Kaiser Family Foundation.

WORKS ENCOURAGED the new legislators to resist efforts by bankers to remove a mortgage fee charged by Allen and other counties. The fees generate about $90,000 a year in Allen, or the equivalent of nearly 1 mill of property taxes, he said.
“We’re the lowest entity on the political food chain,” Works said of counties and municipalities, and whenever the Legislature pares a funding source the only recourse is to increase property taxes, or find a way to do without revenue.
Thompson has a firm grasp of that concept, having served 12 years as a county commissioner. He also is in real estate sales, which gives him insight to the mortgage fees, which he said paled in comparison to bank charges made when real estate transactions occurred.
Lusker said he would be reluctant to support funding cuts at the state level, noting, “We have things that we have to do … and the money has to come from somewhere.” Cuts, he added, often “trickle down to tax increases for cities and counties.”

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