Bi-partisan Medicaid expansion breakthrough announced

Gov. Laura Kelly and state Sen. Jim Denning on Thursday announced a bi-partisan plan to expand Medicaid, which could provide health care coverage for approximately 150,000 Kansans.

The announcement represents a milestone in the battle to make Kansas the 37th state to expand health care, but Kelly, Denning and advocates cautioned that the fight will continue during the 2020 session that starts Monday to bring the plan across the finish line.

“We are not here to declare victory,” Kelly said. “We have a long way to go in this process.”

Denning, R-Overland Park, who is the Senate Majority Leader, said the bill will have 22 co-sponsors in the 40-member Senate.

Last year, an expansion plan was approved in the House but blocked in the Senate. The Legislature approved a plan in 2017 but then-Gov. Sam Brownback, a Republican, vetoed it.

Under the new proposal, expansion will occur no later than Jan. 1, 2021. The federal government will fund approximately 90 percent of the cost with the rest made up by a hospital surcharge.

Kansas’ Medicaid program covers over 341,000 low-income, elderly and disabled Kansas residents. But non-disabled adults without children don’t qualify, and adults with children must have incomes well below the federally set poverty level to be eligible for coverage. The proposal would provide coverage to families earning up to 138 percent of the federal poverty level.

Kelly and Denning said the compromise includes portions of earlier Democratic and Republican plans and House and Senate plans.

Kelly, who has made Medicaid expansion her top priority, said of the back-and-forth negotiations, “Compromise is hard, it is messy and it’s slow, but it is so worth it.”

KASB’s position has been to support efforts to ensure all children have access to health care and oppose efforts on the federal level to reduce funding or eligibility for school-based special education services under Medicaid.

Here are some details from the compromise plan outlined by Kelly and Denning:

— Full Medicaid Expansion: The proposal includes a full expansion of Medicaid to 138 percent of the Federal Poverty Level (FPL) with a 90/10 match, to be effective no later than January 1, 2021.

— Promoting Personal Responsibility: The agreement includes a robust work referral program that promotes self-reliance for non-working Medicaid beneficiaries, while limiting costly administrative red tape that drives up overall costs to taxpayers. Enrollees within the expansion population will make a modest contribution for health services through monthly premiums of up to $25 per month, or $100 for a family of four, as proposed in House Bill 2066. The bill does not contain any lockouts. Instead, it collects unpaid premiums through the state’s debt setoff program. A hardship provision is also included.

— Rural Health Care Innovations: The proposal creates an advisory committee within the Kansas Department of Health and Environment to support rural hospitals in assessing viability and identifying new delivery models, strategic partnerships and implementing financial and delivery system reform to improve the health of rural communities.

— Medicaid Funding: The proposal includes an annual hospital Medicaid expansion support surcharge of up to $35 million, which has been endorsed by the Kansas Hospital Association, to be effective July 1, 2021. This compromise proposal does not require a tax increase.

— Reinsurance: Pending Centers for Medicare and Medicaid Services (CMS) approval of a 1332 waiver and release of funding by the State Finance Council, the proposal includes a reinsurance program to be effective no later than January 1, 2022. The agreement also requires the Kansas Insurance Department to complete an actuarial study of the reinsurance proposal and submit to the State Finance Council.

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