By JIM MCLEAN
Add the Wichita Metro Chamber of Commerce to the list of Kansas organizations that support expanding Medicaid to cover more low-income adults.
Pushed by influential hospital members Via Christi Health and Wesley Medical Center, the chamber’s board voted Thursday to add expansion to its list of policy priorities for the 2016 legislative session, said Jason Watkins, the organization’s lobbyist.
But, Watkins said, the chamber’s support is conditional. Expansion must be revenue neutral, meaning it cannot increase state spending. And it must require non-disabled adults to work or participate in job training to qualify for coverage, a condition that could make it a tough sell to federal officials.
“I want to be clear, if a program comes out and it costs the state $100 million a year, that’s not what we’re supporting,” he said.
About 70 percent of the members who responded to a survey used to formulate the chamber’s positions supported Medicaid expansion, Watkins said. However, 45 percent said their support was contingent on the plan being revenue neutral.
The chamber’s conditions mirror two of the three set by Gov. Sam Brownback. In addition to budget neutrality and a work requirement, the governor has said he won’t consider an expansion plan that doesn’t also extend Medicaid support services to thousands of Kansans with physical and developmental disabilities who are now on waiting lists.
Opposition from Brownback and Republican legislative leaders has prevented debate on expansion the past two legislative sessions. But the recent closure of Mercy Hospital in the southeast Kansas community of Independence has made some lawmakers open to considering a plan like those crafted by conservative Republican governors in other states.
Expansion advocates, including Kansas hospital leaders, have said they’re eager to work with Brownback and others to craft a plan that meets their conditions. But it’s not clear how that can be done given the cost of meeting them.
The Kansas Department of Health and Environment, the state’s lead Medicaid agency, has estimated that eliminating the waiting lists for Kansans with disabilities will cost the state about $1 billion over 10 years. Covering that additional cost while keeping an expansion plan budget neutral will be no easy feat.
Still, Tom Bell, president and CEO of the Kansas Hospital Association, is encouraged by the Wichita Chamber’s support. He said it gives the issue more momentum heading into the 2016 session, which begins in January.
“Plus, it’s an indication that this is a business issue as well,” he said.
Watkins agreed, saying the chamber’s members realize that providing health coverage to more Kansas adults could lower their cost of doing business.
“The Wichita business community understands that we have folks going to hospitals and getting care, and the hospitals are not being paid because these people don’t have coverage,” Watkins said. “At the end of the day, it’s the business community that is paying for those people. It (the cost) gets passed through and increases the premiums that our business owners are paying for their employees.”
The Kansas Medicaid program was renamed KanCare in 2013 when the Brownback administration privatized it by signing contracts with three managed care organizations.
Expanding KanCare would provide coverage to roughly 150,000 Kansans earning less than 138 percent of the federal poverty level: annually $16,105 for an individual and $32,913 for a family of four.
A study done for the hospital association said that the billions of additional federal dollars from expansion would stimulate the Kansas economy and boost state tax collections. The amount of federal money lost to date because of the state’s rejection of expansion is approaching $835 million, according to a ticker on the hospital association’s website.
Bernie Koch, executive director of the Kansas Economic Policy Council, a group formed by local chambers of commerce and trade organizations to counter the increasingly conservative agenda of the Kansas Chamber of Commerce, said the Wichita Chamber’s support of expansion, however qualified, could influence the legislative debate.
“I think it’s meaningful because it puts these conservative legislators who have been opposed to Medicaid expansion in an uncomfortable position,” Koch said.
The tension around the expansion issue is evident in another Wichita-based business organization. The Wichita Independent Business Association also surveyed its members, many of whom are small-business owners, on the issue. But Lon Smith, WIBA’s new president, was not eager to publicly discuss the results.
“I’m not inclined to really speak about that, to be honest with you,” Smith said. “We do those surveys on behalf of our members and use the information to represent them, not to take a public stance or to try to sway the public one way or the other on issues.”
The survey question on expansion generated a higher than usual response from members, Smith said, although he declined to provide the results.
However, others claiming to be familiar with the WIBA survey, who asked that their names not be used, said respondents favored expansion by a wide margin.
Jim McLean is executive editor of KHI News Service in Topeka, a partner in the Heartland Health Monitor team.
