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Open to expansion

Good for Senate President Susan Wagle, R-Wichita, for being open to expanding Medicaid in Kansas. The rest of the Legislature and Gov. Sam Brownback should be, too.

During a debate last week on an amendment to require legislative approval for any effort to expand Medicaid, Wagle said she supported the amendment (which passed), but not because she was trying to block expansion.

"We need to remain flexible here in this state and find our own Kansas-based solutions," Wagle later told the Topeka Capital-Journal. "If that means drawing down some of those federal funds, we need to be flexible in how we draw them down."

That's smart.

A study by the Kansas Hospital Association concluded that expansion would enable more than 150,000 Kansans to get needed insurance. It also would inject more than $3 billion into the state's economy and create 4,000 jobs over the next seven years. What's more, expansion could save the state more money than it costs.

Conversely, not expanding Medicaid would be a major financial blow to the state's hospitals. That's because the Affordable Care Act reduces payments to help hospitals that serve low-income uninsured patients (in expectation that many of these patients would be joining Medicaid). Losing this funding could put some small hospitals out of business.

Wagle is interested in crafting more of a free-market approach to expansion. She has cited Arkansas, which has received preliminary approval to use federal Medicaid money to help low-income residents pay premiums for private insurance (an idea that is similar to the Obamacare insurance marketplace).

"One thing we need to do is keep doors open, keep talking and keep trying to find Kansas solutions," she said.

Wagle's pragmatism isn't out of character. In 2008, she supported an expansion of the State Children's Health Insurance Program in Kansas. She called SCHIP a "tried-and-true program" and noted that the federal government would pick up most of the cost of expansion.

That's even more the case now, as the federal government will cover the full cost of this expansion until 2016, and nearly all the cost afterward.

Wagle also has noted that if Kansas doesn't opt in to Medicaid expansion, other states that do will benefit from Kansans' tax dollars.

"Kansas is losing out, and it does affect our health care industry and it does affect the quality of our services," she told the Lawrence Journal-World.

For his part, Brownback remains noncommittal, even as more than half a dozen GOP governors recently have announced they are expanding Medicaid in their states.

"We're open on it," Brownback said. "We're very concerned about the long-term costs. I want to listen to the Legislature."

He should start by listening to Wagle.

Editorial by the Wichita Eagle