Medicaid expansion

The uninsured rates in Kansas and Missouri continue to drop, but not as fast as those in states that have expanded their Medicaid programs.

New numbers from the U.S. Census Bureau show the uninsured rate in Kansas dropped to 8.7 percent in 2016 from 9.1 percent the year before. That is not a statistically significant change.

Approximately 249,000 Kansans lacked health coverage in 2016, down from about 261,000 the previous year.

The uninsured rate in Missouri declined to 8.9 percent from 9.8 percent the previous year.

The health care plan unveiled last month by the Republican-controlled U.S. Senate met with fierce opposition from hospital, doctor and patient advocacy groups. Among them was the National Rural Health Association, which is based in Leawood, Kansas, and represents doctors, nurses and hospitals in rural areas nationwide. 

U.S. SEN. PAT ROBERTS WEBSITE

Kansas U.S. Sen. Pat Roberts is not enthusiastic about the Senate’s version of the Obamacare replacement bill.

Nevertheless, he supports it.

Three weeks after Blue Cross and Blue Shield of Kansas City said it will pull out of the Affordable Care Act exchange in 2018, Centene Corp. says it plans to offer coverage through the exchange in Missouri and Kansas.

The St. Louis-based insurer already has a presence in both states administering Medicaid plans, but the move to sell individual and small group health plans is new.

Another poll has found strong majorities of Kansans support expanding Medicaid, but some political experts say it isn’t likely to make a difference this legislative session.

The latest Medicaid expansion poll found about 68 percent of Kansans surveyed said they supported expanding the program to non-disabled adults who earn up to 138 percent of the federal poverty line, or annual income of about $16,600 for an individual and $33,400 for a family of four. About 60 percent of Republicans polled said they also supported expansion.

Republican leaders in the Kansas House say it is unlikely they will schedule another vote on Medicaid expansion in the final weeks of the legislative session.

But Democrats say they will attempt to force one.

House Majority Leader Don Hineman, a Dighton Republican, said lawmakers facing tough votes on the budget, taxes and school finance don’t want to further complicate the final weeks of the session by adding Medicaid expansion to the mix.

A third of the way to an end-of-year deadline, Kansas officials still do not have federal approval to extend KanCare.

In January, the federal Centers for Medicare and Medicaid Services denied the state’s request for a one-year extension of the waiver that allowed it to privatize its Medicaid program. The denial letter said neither the Kansas Department of Health and Environment nor the Kansas Department for Aging and Disability Services was doing enough to hold the three private companies that run the program responsible for providing services accountable to Medicaid rules.

Renewed attention to the financial struggles of several Kansas hospitals is giving supporters of Medicaid expansion a potentially powerful argument as they work to build a veto-proof majority for a new bill.

“The conversation became much more real with the renewed talk about hospital closures,” said David Jordan, director of the Alliance for a Healthy Kansas, a pro-expansion coalition. “I think legislators are seeing how motivated their constituents are and maybe rethinking their votes.”

Dallas Morning News

In 2015, Texas spent almost half of its budget on healthcare—a total of nearly $43 billion. Now, as health costs spiral out of control, the Lone Star State is trying to figure out how to assure the health of the state’s residents, while still paying for state worker insurance, prison inmate health, and disabled benefits.

Kansas City Star

The Kansas Legislature does not have sufficient votes to override Governor Sam Brownback’s veto of the state’s Medicaid expansion, reports The Kansas City Star.

Last week the Governor sent health-care advocates into a rage by vetoing a law that would have provided health care to roughly 150,000 low-income Kansans. The law would have opened the door to millions of dollars’ worth of Federal matching funds.

Gage Skidmore / Wikimedia Commons

In a move that has infuriated health advocates in his state and across the country, Kansas Governor Sam Brownback vetoed a measure last week that would have expanded Medicaid across the state.

As The Kansas City Star reports, the decision means 150,000 more Kansans will go without health care than if he had signed it. The bill passed the Senate in a 25-14 vote, and passed the house by a similarly wide margin of 81-44.

A motion to override Gov. Sam Brownback’s veto of a bill that would expand Medicaid eligibility failed Monday in the Kansas House, 81-44. At least 84 votes were needed to override the veto and move the bill to the Senate.

Supporters of expanding Medicaid eligibility in Kansas are preparing to mount an intense lobbying campaign over the weekend to get the votes they need to override Gov. Sam Brownback’s veto of an expansion bill.

Editor’s note: This story was updated at 4:30 p.m. March 30.

Gov. Sam Brownback on Thursday morning vetoed a bill to expand Medicaid eligibility in Kansas, spurring a short veto override effort in the Kansas House that likely will continue next week.

Editor’s note: This story was updated at 11:20 a.m. Tuesday, March 28.

Buoyed by the failure of Republicans in Congress to repeal the Affordable Care Act, the Kansas Senate on Tuesday gave final approval to a Medicaid expansion bill in a 25-14 bipartisan vote.

The Senate vote sends the bill to Republican Gov. Sam Brownback, whose spokeswoman reaffirmed his opposition to expansion in tweets during nearly three hours of Senate debate Monday but did not say whether he would veto it.

Kansas lawmakers are now a step away from what could be a showdown with Republican Gov. Sam Brownback on the political football issue of Medicaid expansion.

KCUR

A bill that would have expanded Medicaid in Kansas was tabled Monday by the House Health and Human Services Committee.

As The Wichita Eagle reports, the action effectively ends chances that the bill will be passed this session under legislative deadlines.

Feds reject Kansas' request to extend KanCare

Jan 23, 2017
KanCare.ks.gov

Federal officials have rejected Kansas’ request to extend KanCare, the state’s privatized Medicaid program, saying it has failed to meet federal standards and risked the health and safety of enrollees.

As reported by The Wichita Eagle, federal investigators reviewed the state’s Medicaid plan in October and found that Kansas is “substantively out of compliance with Federal statutes and regulations, as well as its Medicaid State Plan,” according to a letter sent to the state Jan. 13 from the Centers for Medicare and Medicaid Services (CMS).

AP PHOTO

In his State of the State address Thursday, Colorado Gov. John Hickenlooper proposed boosting rural access to high-speed Internet.

To boost economic development in rural areas, one of the governor’s proposals is to create an office focused on expanding broadband Internet access to the 30 percent or so rural households in the state that don’t have it, with an overall goal of ensuring that 100 percent of rural houses have it by 2020.

According to a recent study, Obamacare’s expansion of Medicaid coverage to people living just above the poverty line may be responsible for more disabled people getting jobs.

As Reuters Health reports, prior to passage of the Patient Protection and Affordable Care Act (ACA), Obamacare, in 2010, people with disabilities and low income jobs were often unable to afford their expensive medical care. Many opted for unemployment in order to qualify for Medicaid coverage.

Khampha Bouaphanh / Fort Worth Star-Telegram

Rural Texas residents have struggled to find adequate healthcare for a long time. In the last three years alone, fifteen rural hospitals have closed in Texas.

In fact, the American College of Emergency Physicians has given the Lone Star State an F when it comes to providing emergency care access to small town residents.

KCUR

Health care advocates in Kansas say they will move forward with legislation that would expand Medicaid in the Sunflower State, despite the election of Donald Trump.

As KCUR reports, the nationwide elections this month may signal an end to Obamacare. And Kansas Medicaid expansion advocates are much less optimistic about the future than they were a month ago. But they’re moving forward anyway.

Todd Wiseman / Texas Tribune

Several key Texas lawmakers have shown little interest in expanding Medicaid in Texas, according to The Texas Tribune.

NewsOK.com

Oklahoma’s state Medicaid director has resigned, reports NewsOK.com.

Nico Gomez announced his exit on Monday in a letter to the Oklahoma Health Care Authority board. The news comes after Gomez spent 20 years in public service, including 16 years at the Health Care Authority.

Brent Fuchs / The Journal Record

In Oklahoma, insurance revenues for home health care dropped last year in comparison to previous years. At the same time, the price of home healthcare rose 2.5 percent over last year, reports member station KGOU. In fact, healthcare costs are rising in every area of health care in Oklahoma.

It’s not just in Oklahoma; home health care costs are going up nationwide. The reason? More Medicare providers are trying to keep chronically ill patients out of hospitals.

cfah.org

Potter and Randall Counties in the Texas Panhandle have been making incremental improvements when it comes to overall child well-being. Even so, as Amarillo.com reports, both counties continue to rank at or below average when compared with the nation at large. A new report measured child well-being in four areas: economic well-being, education, health, and family and community. Texas as a whole is ranked 43rd in the nation.

There's a new study out. It shows that health providers in states that expanded Medicaid are doing much better than providers in states that didn't expand the program.

KUT

Health care providers received some welcome news this week. According to KUT and The Texas Tribune, the Obama administration has agreed to temporarily keep federal Medicaid money flowing into the Lone Star State. The money will go toward helping hospitals treat uninsured patients.

State of Arkansas

From the Kansas Health Institute:

Arkansas Gov. Asa Hutchinson on Thursday signed an appropriation bill into law and used a line-item veto to ensure continuation of the state’s Medicaid expansion, ending a two-week budget standoff.

The Medicaid expansion covers more than 267,000 Arkansans who make less than 138 percent of the federal poverty level (annually about $16,000 for an individual or a little more than $33,000 for a family of four).

Center for Rural Affairs

Over the past six years rural hospitals have been closing at a rate of nearly one per month, according to the Center for Rural Affairs. A hospital closure can be very hard on a rural hospital. But it doesn’t have to be this way, says the CFRA.

The closings have been especially widespread in the 18 states that have refused to expand Medicaid. Those states include Texas, Oklahoma, and Kansas.

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