Sheldon Weiagrau, director of the Health Reform Resource Project, talks to a group in Hays about Medicare expansion.

Hays Post

A health educator told a group of Hays-area residents Tuesday that Medicaid expansion would not only be revenue positive to the Kansas budget, but boost the state’s economy.

Sheldon Weisgrau, director of the Health Reform Resource Project, a foundation-funded initiative to provide education and technical assistance in the implementation of health reform and the Affordable Care Act, was invited to speak at the Hays Public Library by Women for Kansas.

Women for Kansas is a non-partisan group that aims to promote election of moderate candidates who support moderate policies.

There are several groups who qualify for Medicaid (known as KanCare in Kansas) under the current system including low-income residents with disabilities, low-income pregnant women, low-income elderly and low-income children.

Those making a certain amount of money and who are not covered by health care insurance at their jobs can qualify for plans under the Affordable Care Act. About 90 percent of those people qualify for subsidies.

About 150,000 people in Kansas make too little to qualify for the Affordable Care Act, but do not qualify for Medicaid, Weisgrau said.

She said expansion of Medicaid under the Affordable Care Act was supposed to cover these people in the gap, but Kansas has refused to expand Medicaid, 100 percent of which would have been funded by the federal government in the first three years (2014 to 2016).

Kansas has lost more than $2.2 billion in tax revenue in the last three years by not expanding Medicaid and that number increases by more than $1.9 million every day. This is money that is going to the other 33 states that enacted Medicaid expansion.

“Everyone in this room is a federal taxpayer. The federal government is saying, ‘Here, take some of it back,’ and we are saying ‘No thank you,’ which means your federal tax dollars are going to California and Colorado and Massachusetts and all the other states that have accepted this program and it is not coming back to the state of Kansas,” Weisgrau said.

Now the federal government is paying 95 percent of the cost of Medicaid expansion, which will eventually go down to 90 percent.

The Kansas Legislature passed a measure to expand Medicare in Kansas during the last session. However, it was vetoed by Gov. Brownback, and the Legislature was just shy of enough votes to override the veto.

Brownback and other opponents of the Medicaid expansion have argued the expansion would be too costly to the state’s budget. Weisgrau disagreed.

Kansas pays 45 percent of the care for Kansas residents who are currently on Medicaid. If the state would move some people who qualify for Medicaid to the federal Medicaid expansion, there would be cost saving, because the cost to the state would shift from 45 percent to 10 percent.

Weisgrau gave the example of a low-income woman. If that woman becomes pregnant, they qualify for Medicaid for the duration of her pregnancy then they fall off the Medicaid rolls. If she was continuously enrolled in Medicaid under Medicaid expansion, the state would only pay 10 percent of her care during pregnancy and delivery instead of 45 percent.

There are people with disabilities that could also be covered under Medicaid expansion for similar savings.

“If you look at the budget, which we have done very carefully, not only will this not cost Kansas money, but we will save enough money to completely pay for this,” Weisgrau said.

In addition, the three managed care companies that provide insurance to KanCare recipients each pay a privilege fee to the state for each person they cover. Covering another 150,000 would increase privilege fee revenue for the state.

Most of the states that have implemented Medicaid expansion have seen a 1 percent growth in GDP. In Kansas expansion of Medicaid would create an estimated 3,800 jobs. Based on population, Ellis County could expect $4.3 million in new health care spending and addition of 27 new jobs. Because Hays draws patients from smaller outlying communities, those figures are likely conservative.

The millions in revenue Medicaid expansion would bring the health care industry could be especially critical to small, rural hospitals. Thirty rural hospitals in Kansas are classified as financially vulnerable.

A big hit in these hospitals’ bottom lines is uncompensated care. Federal law dictates if someone comes to the emergency room, they have to be evaluated and treated for acute conditions, including women in active labor. Hospitals rarely are able to collect payment from uninsured patients.

Medical debt is the No. 1 reason for bankruptcy in the United States. When uninsured patients can’t pay, it ruins their credit and inhibits their ability to land a good job, get a loan for a car or qualify for a mortgage.

Weisgrau said we need to dispel the myth of the “Welfare Queen.” There are people who take advantage of the system, but that is not true in most cases.

“This is a real way out of poverty,” Weisgrau said. “Most of the people who fall in the gap work or are sick. … Medicare helps people get jobs and creates a path out of poverty and a way to economic security.”

Weisgrau said people who support Medicaid expansion in the state should contact their local state representatives and senators. Rep. Eber Phelps, D-Hays, and Sen. Rick Billinger, R-Goodland, both voted in favor of Medicaid expansion during the last session. Rep. Ken Rahjes, R-Agra, voted against.

In surveys, 70 to 82 percent of Kansans support Medicaid expansion. Sixty-six percent of Republican voters support it.

“This is not a controversial issue,” he said. “It is not a partisan issue. There are some legislators who are honestly not representing their communities.”

To join the Alliance for a Healthy Kansas in support of Medicaid expansion or find other material supporting Medicaid expansion, visit

Also like the group on Facebook @ExpandKanCare or follow them on Twitter at /ExpandKanCare.

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Speaker: Medicaid expansion could help state budget