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Kan. hospitals urge no statement on Medicaid move

2/2/2013

TOPEKA, Kan. (AP) -- Some Kansas hospital administrators and medical groups urged legislators Friday to postpone any formal policy statement on expanding Medicaid as a House committee considered a measure critical of the move encouraged by the federal government's health care overhaul.

The House Appropriations Committee had a hearing on a resolution declaring that the Legislature doesn't intend to make tens of thousands of additional people eligible for Medicaid, which covers health care for the needy and disabled. The resolution reflects skepticism that the federal government will keep its promise to pay almost all of the costs associated with the expansion.

The Kansas Hospital Association and the state Department of Health and Environment released conflicting studies this month on the potential costs to the state if Medicaid was expanded. The hospital group's report suggests the state would see a net financial benefit, but the KDHE study said the state would face an additional $600 million in costs over the next 10 years.

The hearing came only days after Florida Gov. Rick Scott proposed expanding Medicaid in his state for the next three years, becoming the seventh GOP governor to embrace an expansion under the 2010 federal health care law championed by Democratic President Barack Obama. In Kansas, Republican Gov. Sam Brownback is a vocal critic of the health care overhaul but has said he'll leave the decision about expanding Medicaid to state lawmakers.

The GOP-dominated Kansas Legislature has shown no inclination to expand Medicaid, and the resolution reiterates criticisms circulating among Republicans. Several GOP members of the Appropriations Committee were sympathetic and one, Rep. David Crum, of Augusta, who also is chairman of the House Health and Human Services Committee, testified for it.

"Many have complained about our escalating national debt," Crum told the committee. "However, do we have the right to complain if we make every effort to pull down additional federal dollars by expanding Medicaid?"

A vote on the resolution hasn't been scheduled yet but could come as early as next week.

But Kansas Hospital Association President Tom Bell said legislators should wait to see how the federal health care law plays out before making a policy statement. He said that view is widely held by hospital administrators.

"We hope that we don't tie the state's hands," Bell said. "Why do we need to pass this right now, given the fact that maybe there are some outstanding questions?"

At the end of last year, about 343,000 people in Kansas were covered by Medicaid, and another 50,000 children in a working-class program were covered by the Children's Health Insurance Program.

Even without expanding Medicaid, state officials expect participation in both programs to increase. They believe publicity about the federal health care law -- which mandates that most Americans purchase health insurance, starting in 2014 -- will spur interest in Medicaid and CHIP.

The KDHE study, prepared by Aon Hewitt, a global actuarial and human resources firm based in Linconshire, Ill., projected enrollment in the two programs will expand by nearly 42,000 by 2016, even without a Medicaid expansion, costing the state $515 million over the next 10 years.

The KDHE study projected that with an expansion, the state would see its enrollment in Medicaid and CHIP grow by 226,000 by 2016 -- so that more than 20 percent of the state's population would be covered. With an additional $600 million in costs from the expansion, the total 10-year cost to the state would exceed $1.1 billion, the study said.

Critics of an expansion question not only whether the state can afford it but doubt that the federal government can afford its share, given its annual budget deficits and its growing debt. Larry Halloran of Wichita, vice president of the tea party-aligned Kansans for Liberty, suggested in a statement that expanding Medicaid was "pinning IOUs to the blankets of newborns."

But the Hospital Association's study, prepared by George Washington University and an Amherst, Mass., research firm, Regional Economic Models Inc., said the Medicaid expansion would create jobs in health care and lower some state social services costs. Its analysis said that over the next seven years, the state would save $82 million.

Representatives of more than a dozen health care providers and groups submitted written statements against the proposed resolution. Some said expanding Medicaid would ensure more Kansans receive good health care.

"It is about believing that all Kansans matter and should have the opportunity to be healthy and productive," Cathy Harding, executive director of the Kansas Association for the Medically Underserved, said in her statement.

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The resolution on Medicaid is HCR 5013.

Online:

Kansas Legislature: http://www.kslegislature.org

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