Kansas State University


Issues in Health Reform

Month: April 2014

Report argues for Medicaid expansion in Kansas

A recent report from the Kansas Center for Economic growth makes the case the expanding Medicaid would be good for Kansas local economies, especially rural communities, and the state as a whole. “Medicaid expansion would go a long way toward increasing economic security for uninsured workers.  It also would be an asset for small businesses—which will benefit from healthier and more productive employees—and the economy as a whole—which will benefit from the flow of federal dollars into the state.” The report details the types of occupations, and the wages in those occupations, where working class people are most likely to be uninsured and eligible for Medicaid if the state chose to expand within new federal guidelines.

The Affordable Care Act was crafted in a way that relied on states expanded their Medicaid programs to cover individuals who made less than 133% of the federal poverty line (138% in actuality when tax deductions were considered).  The federal government is set to pick up 100% of the expenses for 3 years and then 90% thereafter.  The Supreme Court decision of June 2012 made Medicaid expansions voluntary.  Kansas is one of 25 states that has not chosen to expand.



Where are we now that open enrollment has closed?

It’s been a busy few months as we reached the ACA enrollment deadline.  There are lots of reports of how many are actually enrolled (about 8 million with the latest report).  The White House also announced that 35% of those who signed up for coverage were under 35. Twenty-eight percent are between the ages of 18 and 34, falling just shy of the administration’s 40% target. This demographic is needed to keep premium levels down, and to offset the costs of insuring older, and likely sicker, enrollees.
As importantly there have been several recent surveys showing that the rates of the uninsured are dropping.  For a good summary of those reports and explanations of what they mean see http://www.californiahealthline.org/articles/2014/4/17/surveys-highlight-acas-effect-on-us-uninsured-rate
Because some consumers will be eligible for special enrollment periods and KanCare enrollment is year-round, we expect to see the insured rate increase over time. We will be sure to pass along the most recent data on the number of Kansas’s successful enrollments as they are made available – so stay tuned!
There are important questions to be answered and I suspect we will see research trying to answer these in the coming months:
•    Who is still uninsured?
–    What are their options?
–    What will states do re Medicaid expansion?
•    Who is now uninsured who was previously insured?
–    Some very high cost counties, region and age
–    What happened with cancellations? Who was affected? Is new option better?
–    Did mandate work consistently across populations?
•    Is insurance affordable?  In whose terms? And through time (are premiums rising more or less than before?)
•    Has more insurance led to better health outcomes for individuals?  How has it affected community vitality?