Poll finds Kansans support budget-neutral Medicaid expansion

Kansans overwhelmingly support expanding a budget-neutral Medicaid proposal, a poll released Monday said, but the chairman of the House health committee challenged the “budget-neutral” aspect of the KanCare Bridge to a Healthy Kansas Program.

The legislation, proposed in House Bill 2633 and Senate Bill 371, has been promoted by the Kansas Hospital Association and other proponents of KanCare expansion as budget neutral, with the potential to generate revenue for the state.

This year’s poll replicated results from previous years in that two-thirds of Kansans, 62 percent, are in favor of expanding Medicaid, or KanCare, to include 150,000 Kansans who are at 130 percent of federal poverty level, according to Cindy Samuelson, KHA vice president of public relations and political fundraising.

But this year, the organization added a question concerning the Bridge to a Healthy Kansas legislation, which KHA says is budget neutral and takes points from a conservative Indiana plan that requires recipients to contribute to their own health care, Samuelson said.

Seventy-six percent of Kansans polled said they would support expanding Medicaid under such a budget-neutral plan, she said.

“Among Republicans, support ranged from 74 to 77 percent when eligibility requirements were explained; among Independents, support reached 82 percent; and among Democrats, support was 71-74 percent,” a release on the poll said.

But Rep. Daniel Hawkins, a Republican from Wichita who chairs the House Committee on Health and Human Services, said a fiscal note on the bill concerning the KanCare bridge program found it wasn’t budget neutral, which negates the poll results on that question.

“I’ve looked really closely at that budget-neutral proposal, and it’s so budget neutral that there’s a $20 million cost to SGF (State General Fund), and $35 million in administrative costs,” he said. “So it’s not budget neutral.”

In addition to those costs, delineated by the Kansas Department of Health and Welfare in its fiscal note, Hawkins pointed to a “woodwork” effect that he said has come into play in other states. He referred to the idea that once Medicaid is expanded, people who hadn’t been using it but were qualified would “come out of the woodwork,” therefore increasing enrollment numbers. He said that would cost an additional $25 million.

Sheldon Weisgrau, director of the Health Reform Resource Project, which is funded by Kansas health care grantmakers, said the fiscal note contains no details about where KDHE got the numbers that Hawkins quoted.

Specifically, the fiscal note dated Feb. 23 found that the KanCare bridge proposal would cost $20.5 million in fiscal year 2017, if implemented, and $44.7 million in FY 2018.

Weisgrau pointed to another study, put forth by KHA and others, that goes “into very deep detail about the budget impacts of expansion, from the cost of the new enrollees to any off-setting costs that are currently in the budget.”

Weisgrau, who joins other health care and business leaders from hospitals, chambers of commerce and others in the state for calling for open, public debate on the topic, said he understands concern about the proposal’s effect on the budget.

“That is exactly the reason why we need to have an open transparent debate about this issue, because without that, all you’re going to do is getting one side throwing out a number and the other side throwing out a number,” he said.