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Medicaid expansion bill good for all Kansans

Ximena M. Garcia
Special to Gannett Kansas

Healthier Kansans are good for our state on every level. Healthier citizens create a better economy, better schools and a better community.

Sen. Denning and Gov. Kelly deserve the highest praise for proposing a Medicaid expansion bill that is good for all Kansans. Although not perfect, the compromise that was reached is worthy of our full support. It will provide affordable health care to the greatest number of Kansans and, at the same time, is intentional and frugal with tax-payer dollars.

The bill includes full Medicaid expansion, a reinsurance program and creates an advisory committee to support rural hospitals and communities — areas most in need of health care in today’s world. It also contains many provisions making sure that the expansion is revenue-neutral to the state.

The expansion would extend Medicaid eligibility to Kansans earning up to 138% of the federal poverty line: For a family of four, this means a gross annual salary of $34,638. Although there will be premiums of $25 per person per month, up to $100 per family, unpaid premiums will not result in a lock-out. Instead, they will be collected through the established debt set-off program, which is a debt collection program that already exists and works by withholding money from state payments and applies a percentage toward state and municipal debts.

From a medical perspective, the no-lockout component is extremely important because it allows for continuity of care, and all patients continue receiving medical care and prescriptions even if their payment is delayed. This reliable access to medical care is especially important for the sickest patients and those with chronic diseases.

In the long run, uninterrupted care is financially prudent because medical issues can be addressed on an ongoing basis instead of waiting until illnesses have become advanced and more complicated and more expensive to take care of.

The proposed bill also includes a work referral program. Similar initiatives have been effective in other states, plus have much lower administrative costs than work requirement programs. Work requirements have been shown to be costly to administer and ineffective thus the selection of a referral program in lieu of a requirement makes sense because it is efficacious as well as financially sound. It is an effective use of state dollars.

Additionally, the bill creates an advisory committee within the Kansas Department of Health and Environment whose function is to support rural hospitals. Rural hospitals and communities are facing a severe crisis, not only having enough physicians to provide both general and specialized care but also just trying to keep their doors open.

The beauty of the proposed Medicaid expansion bill awaiting debate in the chambers of the Statehouse is that it has been crafted focusing on improving the health of all Kansans. Not only will it help more low-income Kansans access health insurance to remain healthy and contribute positively to the state and the economy, but it also benefits all Kansans by keeping hospitals viable in communities large and small across the state.

This process is an example of lawmakers putting politics aside and working together to create policies aimed directly at benefiting their constituents. They are actively making Kansas a better place.

I, for one, am hoping this is the first of many cooperative policies created to benefit Kansans in 2020.

Ximena M. Garcia, M.D., is a retired physician who lives in Topeka.