By Jim McLean
KHI News Service
TOPEKA — The chief executive of the Kansas Hospital Association is using a recent report about uninsured veterans to make the case for Medicaid expansion.
In an opinion piece sent to newspapers on Wednesday, Tom Bell said approximately 15,000 Kansas veterans and 10,000 of their family members lack health insurance, according to the report written by the Urban Institute with funding from the Robert Wood Johnson Foundation.
In Missouri, approximately 30,000 non-elderly veterans and 22,000 of their family members are uninsured.
About half the uninsured veterans and their family members in both states would qualify for Medicaid, if eligibility for the program were expanded to 138 percent of the federal poverty level – $32,913 for a family of four, the report said.
Currently, in Kansas, able-bodied adults are eligible for the Medicaid program – called KanCare – only if they have dependent children and earn less than 33 percent of the poverty level, which for a family of four is $7,770 annually. No matter their income, Kansas adults without children are ineligible unless they are disabled.
It’s one thing to be forced to wait months for care, Bell wrote, referring to recent revelations about long waiting lists at Veteran’s Affairs medical centers across the country. But it’s another, he said, to have no access to care.
“Unfortunately, this is happening in Kansas,” he wrote. “It’s the job of elected state officials, including our governor, to help veterans and their family members gain access to that line. That could easily be done by expanding coverage and access to care for our veterans and for thousands of other hard-working
individuals through Medicaid expansion.”
The Urban Institute report said that uninsured veterans are more likely to be younger, less educated and to have served more recently than veterans who have insurance. In addition, the report said, they are less likely to be married or connected to the labor force, “all of which could contribute to lower access to employer-sponsored coverage.”
The hospital association and a coalition of advocacy groups have been pushing for expansion since January 2012. But they’ve made little progress. In the just-ended legislative session, Republican leaders refused to hold a hearing on a bill that would have authorized expansion.
Gov. Sam Brownback, a conservative Republican seeking a second term, hasn’t shut the door on expansion. But he has expressed concerns about its cost and has said he doesn’t want to add able-bodied adults to the Medicaid rolls when Kansans with developmental and physical disabilities remain on waiting lists for services.
“We’re trying to push people who are able-bodied right now to get a job,” Brownback said during a recent interview with a news organization operated by the conservative Heritage Foundation. “That is a far more likely route out of poverty than having a bunch of government programs giving hand-outs to able-bodied individuals.”
Despite his stated concerns, Brownback has said he’s watching attempts by Republican governors in a handful of other states to implement more private-sector versions of expansion – plans that use federal Medicaid dollars to help uninsured adults earning above the poverty level purchase private coverage.
“We’re watching all of it,” Brownback said recently. “I’m more confident today than I’ve ever been that there will be other options out there.”
The Urban Institute classified veterans as uninsured if they had no coverage and didn’t use VA health services. There was insufficient data to determine the number of veterans deemed uninsured who could potentially qualify for or access VA services, the report said.