A newly formed organization, backed by five Kansas health foundations and more than 70 other organizations, will work on a grassroots level to expand KanCare in the state.
Alliance for a Healthy Kansas, which operates a website at ExpandKanCare.com, will be guided, beginning in April, by executive director David Jordan, who brings years of experience in health care policy to the table. He most recently worked nationally on adding mid-level providers to the dental field.
The alliance was announced by Sunflower Foundation President Billie Hall, one of the five health foundations backing it.
“The goal of ExpandKanCare.com is to bring the voices of Kansans into this important policy discussion,” Hall said. At a recent Expand KanCare forum hosted by Sunflower, many expressed frustration that the Kansas Legislature wouldn’t even allow a discussion on expanding KanCare to take place. The idea of a grassroots effort to move the state’s position was discussed.
“I think the vision for this is to start having a community dialogue, making sure the voices of folks in the communities are being heard,” Jordan said. “We see poll after poll showing significant support for expanding KanCare, and it’s critical that legislators are hearing from their constituents that this matters to us.”
A recent poll by the Kansas Hospital Association found that 76 percent of Kansans support a budget-neutral or revenue-producing expansion of Medicaid, or KanCare, Jordan said. Bills have been introduced in the Legislature putting forth a proposal, called the Bridge to a Healthy Kansas, which many of the organizations supporting the alliance believe is budget-neutral.
“This is really an effort to try to lift up and elevate the voices of the hardworking Kansans that support this bill,” Jordan said.
However, some legislators don’t agree the bill is budget-neutral. Rep. Daniel Hawkins, a Republican from Wichita who chairs the House health committee, said it would hit the State General Fund with a bill of $20 million and also cost $35 million in administrative costs.
A study released this week, which was funded by the Robert Wood Johnson Foundation, followed up on previous research indicating that some states that have expanded Medicaid have seen positive influences on their budgets.
The report looked at 12 states that expanded Medicaid and found they are spending less of their state budget on Medicaid-related costs. The report said California has saved $250 million on its 2015 low-income health program, Colorado saved $96 million on 2015 spending related to childless adults who were newly eligible for Medicaid and Michigan saved $19 million on prison health services.
Deborah Bachrach, J.D., was one of the researchers at Manatt Health Solutions, which prepared the report for the RWJ foundation. She pointed to several areas in which states are seeing savings through Medicaid expansion, including coverage of pregnant women, hospital stays by prisoners and through alleviating costs associated with Medicaid spend-down, a category of people who have to spend a certain amount of dollars before they qualify to get coverage.
One southern state saw expenses cut in half after two years just because of the changed coverage of pregnant women, Bachrach said.
The savings often are seen in substituting Medicaid dollars for state general fund dollars, with individuals moving from categories where they are matched with federal funding on a low level, to categories with higher matching funds, she said. For instance, the state substitutes 100 percent state dollars to cover them for 90 percent federal dollars.
Bachrach was one of the researchers of a report on the potential impacts of expanding Medicaid in Kansas that came out late last year.
At that time, Gov. Sam Brownback’s spokeswoman, Eileen Hawley, hinted that the report had political bias.
Bachrach, who works on a national basis with numerous states, said each one is handling the Medicaid expansion differently. Some of the states like Kansas that haven’t expanded still are considering proposals. South Dakota’s governor is even considering a special session over the summer to deal with the issue, she said.
“I think you see different levels of hostility, but you do see Republican governors taking a harder look at it because they have to balance the budget,” she said. “I think the two most fascinating states to look at are Arkansas and Kentucky, where expansion happened under Democratic governors and Republican governors have come in.”
Kentucky Gov. Matt Bevin, who campaigned on reversing the Medicaid expansion, has “blinked,” according to a report in MSNBC. He now says he will look at revamping the program.
“He came in and looked at the dollars, (and said) ‘let’s see how we can modify it to meet Republican principles,’ ” Bachrach said. “The dollars alone, before you think about anything else, were too compelling in either state to enable the governors to conclude they should move away from expansion.”
Jordan said the organizations involved in supporting the Alliance for a Healthy Kansas just want to start the discussion on the issue in a public forum.
“Part of this is making sure we can have the substantive policy conversation with legislators, and that it’s not just people in Topeka having the conversation with legislators, but their constituents across the state,” he said.
In his role leading the alliance, Jordan plans to be active in meeting with Kansans, educating them on the issue and helping them to better connect with their legislators.