The annual effort to expand Medicaid in Kansas cleared one hurdle Wednesday morning. Members of the Senate Public Health and Welfare Committee heard more than an hour’s worth of testimony from advocates and opponents of a controversial Medicaid expansion proposal.
Proponents told the committee the legislation makes sense financially and is the right thing to do. Opponents argued expansion is crushing budgets in the 32 states that expanded Medicaid.
Traditionally, Medicaid covered impoverished pregnant women, children and the disabled. A provision in Obamacare allowed states to offer the entitlement program to able-bodied adults who meet certain income and other eligibility requirements.
Officials estimate expansion in the Sunflower State would provide Medicaid coverage to 150,000 people, but enrollment in expansion states far surpassed initial projections. Cost overruns are also the norm, Gregg Pfister, government affairs director at the Foundation for Government Accountability told the committee.
“Because Kansas said no to expansion when other states rushed in, you have the benefit of seeing this disaster unfold,” he said.
He warned that expansion puts the truly needy at risk. Enrollment in the program is unpredictable and expansion costs are uncontrollable. He said expansion states currently face the possibility of cutting other programs in order to maintain Medicaid expansion.
“Expansion is not unchartered territory,” he said.
Dr. Robert Freelove, a Salina physician and CEO of Salina Family Health Center, told the Senate health committee expansion is the right thing to do. He said people who don’t have insurance often wait to receive healthcare services and that can lead to increased costs. He told the story of a 37-year-old patient holding two jobs, neither of which provided health insurance.
“She waited six months to be seen on breast cancer,” he said. The patient survived, but her recovery would have been simpler and less expensive had she gone to see a doctor sooner.
“We were able to get her the care she needed,” he said. “She’s cancer-free to this day. A happy ending, but at what cost? The pain, suffering, and expense that could’ve been saved.”
He shared similar stories about two other patients who survived illness and injury, but were saddled with medical bills. They would have qualified for Medicaid if the program was expanded, Freelove said.
“If hearing that doesn’t impress upon you how important this is for those people. I don’t know what will. To me, this is the right decision. We’re talking about people and their lives,” he said.
However, James Franko, vice president of the Kansas Policy Institute, said a card of insurance, Medicaid in this case, doesn’t guarantee medical care. He cited an Oregon study that revealed Medicaid recipients didn’t have better health outcomes than those without insurance. The researchers also showed that under Medicaid expansion in Oregon, emergency room visits to treat non-emergencies increased by 18 percent. ER visits increased by 40 percent among Medicaid recipients.
“For every story we’ve heard today and for countless others, there are testimony of others who had Medicaid or others who had insurance and didn’t get the coverage they needed,” Franko said.
Expansion proponents attempted to adopt a similar proposal last year. Legislation passed both the Kansas House and Senate, before being vetoed by then-Gov. Sam Brownback. The health committee didn’t vote on expansion on Wednesday, but passage is likely. Of the nine Senate members, six voted to expand Medicaid last session.
Gov. Jeff Colyer said he isn’t interested in expanding Obamacare. However, he has said he’ll look at any legislation that reaches his desk.