KanCare Expansion forum shares potential Barton County impact

Barton County could see increase in jobs, revenue if expansion allowed

By Veronica Coons, April 24, 2017

Monday night, a forum organized by The Alliance for Healthy Kansas at the Prince of Peace parish hall sought to inform and provide answers about why it’s important now for Kansas to expand Medicaid now, even as President Donald Trump has sworn to repeal and replace the Affordable Care Act. Several Barton County residents, as well as some from neighboring counties attended.

With some confusion over the starting time of the forum, a number of attendees arrived after the presentation started. Some inquired as they entered if the forum would include Rep. Tori Arnberger, Dist. 114, but were disappointed to learn she was not there. Arnberger voted in favor of expansion earlier this session, but reversed her vote and upheld Governor Sam Brownback’s veto.

Costs questioned

David Jordan, Executive Director of the Alliance introduced speaker Sheldon Weisgrau of The Alliance. He argued a popular claim put forth by supporters of Kansas Governor Sam Brownback, that expanding Medicaid would cost the state money it can’t afford to spend. He offered reasons why expansion could help, rather than hinder, the state budget.

Even though the period when the federal government provided 100 percent of the cost of Medicaid expansion has lapsed, and states this year will need to cover five percent of the cost, the savings and revenue that will be generated will offset this cost, he said. Savings would be generated because the current state match of 44 percent of the cost of Medicaid would be reduced to no more than 10 percent, saving more than $60 million in 2019.

In addition, he said, the state receives rebates on prescription drugs, so more people covered would mean more rebates. Also, the state receives a privilege fee on managed care organizations, including the three that administer KanCare, so more people covered means more fees collected. Together, more than $68 million would be generated that isn’t now, according to the organization’s projections. 
In addition, more jobs will need to be filled due to the numbers of people who would seek medical care if covered, who are now deferring basic care because they perceive they cannot afford it. The taxes generated from these incomes, along with the other previous points, Weisgrau said, could provide a net positive impact of $73 million to the state in 2019.

Impact on Barton County

Weisgrau shared what Barton County stands to gain if expansion is allowed, noting that there are currently 1,204 uninsured residents who will gain health coverage. The economic impact that new annual health care spending could generate translated to $5,091,716, and part of that because about 32 new jobs would be created.

He introduced Jim Blackwell, CEO of Clara Barton Hospital in Hoisington, who said that in the last year, the hospital had provided $1.7 million in uncompensated care to patients who had no health care coverage.

“That’s a large dollar for a small hospital in a rural setting,” he said. Early estimates, he said, if expansion occurs, could by $630,000 to help offset that deficit. It’s not just a fiscal impact, he said. Hopefully, if patients get medical attention prior to ending up in the emergency room, that could help to drop the costs of health care further, with fewer costly procedures being required.

Julie Kramp, executive director of The Center for Counseling and Consultation, followed Blackwell. She noted that many people have a stigma about getting mental help, and if they perceive they can’t afford it, they don’t come until a crisis erupts, and then law enforcement may be involved.

“By that time, so many other agencies involved at such a higher cost, and a more prolonged and expensive road to recovery as opposed to seeking help and getting help and knowing that you are going to be covered and you’re going to be cared for,” she said. 
Another point Weisgrau made earlier, she touched on again. People who don’t have health insurance have a harder time achieving good credit, because extensive medical bills can be overwhelming to their budget. Not having good credit, he said, can make it difficult to get hired, and that continues the downward spiral of poverty. Cramp said this inability to find a job because of bad credit can hamper case management for people recovering from crisis situations.

“Often, if you waited until then, you have a record, and you have issues, and its that more difficult to overcome that hurdle,” she said. “Expanding KanCare, providing these services, will make such an impact on the people that we serve. The number of people who are able to go at the right time and get the right services would increase.”

Most are able-bodied, working

Some people in attendance shared stories about family members and others they know who are not eligible for Medicaid, but make too little money to afford health insurance, so aren’t eligible for subsidies in the Marketplace. Jordan said 87 percent of the people who fall into this category are able bodied and working.

He spoke about Susan Evans, who testified in favor of expansion earlier this year. A self employed housekeeper in Iola, she assumed legal guardianship of her grandchildren. Prior to that, she was qualified to receive subsidies in the marketplace, but she lost her eligibility for subsidies because she didn’t make enough money with dependants to qualify. This left her uninsured at the age of 56, putting herself, her dependant grandchildren, and the elderly mother she cares for at risk.

“This is one of many stories that represent the able bodied people who fall into this category that we are trying to help through expansion,” he said.

Jordan asked attendees to contact their representatives and let them know their thoughts on expansion, as another attempt at expansion may occur during the veto session in May.


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