Medicaid: Who is already covered?

This weekend I had an “aha” moment. Every Saturday morning I have breakfast with a group of friends. One of my friends said to me, “Dan why are you not in favor of Medicaid Expansion?” “All I hear about on TV and in the paper is that it costs us nothing and will provide the poor, disabled and elderly with health care. Dan, how can you not support that?” At that point it became clear that even my friends who I talk with all the time have not heard the entire story on who is already covered and who the new additions would be with Medicaid Expansion.

So, I thought it would be a good idea to write a piece outlining who is currently covered by Medicaid. First, let’s start out with the fact that in Kansas we call our Medicaid program KanCare. KanCare currently provides health care to the following populations:

      Pregnant women up to 150% of the federal poverty level (FPL)

      -  Mothers for one year after birth up to 150% FPL

      -  Children whose family incomes are up to 250% of FPL

      -  Parents of children up to 38% of FPL

      -  Those with a qualifying disability through social security administration

      -  Those who are currently applying for and awaiting disability determination

      -  Those with physical disabilities

      -  Those with developmental disabilities

      -  Those with traumatic brain injuries

      -  The frail and elderly

      -  The blind or visually impaired

      -  Children with autism

      -  The state supports community mental health centers to support the mentally ill who are uninsured

      -  The state supports programs to compensate hospitals that treat the uninsured

      -  The state supports safety net clinics, or FQHC’s as they are commonly referred to, to treat the uninsured

So, what population would be included in Medicaid Expansion? It would expand eligibility to “able bodied adults up to 138 percent of the Federal Poverty Level (FPL).”Able bodied adults with other health care options.

Kansas currently has 425,000 people on Medicaid. That is nearly 1/6th of the population. Based on the numbers given in the KDHE study authored by Aon Hewitt, Medicaid Expansion would result in 151,200 newly eligible in 2016. That would result in 1/5th of our population being eligible; yes, 20 percent of our population would be on Medicaid.

But even those numbers may be selling things short. Evidence from other states shows their initial estimates were severely low. In our neighbor to the west Colorado, enrollment came in 207 percent more than expected. If Kansas numbers are off by 207 percent, our Medicaid population would increase by more than 300,000 Kansans, putting more than 25 percent of our state’s population on Medicaid.

I agree with my coffee buddy that the state has a responsibility to provide a healthcare safety net for the poor, disabled and elderly. My concern begins when we expand that to able bodied adults with other health care options.

Dan Hawkins

State RepresentativE 100th District