The chief executives of the Missouri and Kansas hospital associations say thousands of uninsured veterans would be eligible for coverage if Medicaid were expanded in those states.
In an opinion piece that ran in The Kansas City Star on Tuesday, they estimated that more than 37,000 veterans in Missouri and Kansas would qualify for Medicaid coverage under expansion.
Approximately 15,000 Kansas veterans and 10,000 of their family members lack health insurance. In Missouri, 30,000 non-elderly veterans and 22,000 of their family members are uninsured.
The figures come from a May 2012 report by the Robert Wood Johnson Foundation and Urban Institute that analyzed the health insurance status of veterans.
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.
In Missouri, Medicaid eligibility for non-disabled adults is limited to parents with income below 23 percent of the federal poverty level, or about $5,500 annually for a family of four. Adults without dependent children are ineligible regardless of income.
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. Kansas adults without children are ineligible unless they are disabled.
The authors of the op-ed - Tom Bell, head of the Kansas Hospital Association and Herb Kuhn, head of the Missouri Hospital Association - say it's one thing to be forced to wait months for care, referring to recent revelations about long waiting lists at Veteran’s Affairs medical centers across the country. It's another, they said, to have no access to care.
“It’s the job of elected state officials, including our governor, to help veterans and their family members gain access to that line," Bell and Kuhn wrote. "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 Robert Wood Johnson/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 associations and a coalition of advocacy groups have been pushing for Medicaid expansion. So far, they have made little progress. In the just-ended Kansas legislative session, Republican leaders refused to hold a hearing on a bill that would have authorized expansion.
Kansas Gov. Sam Brownback, a conservative Republican seeking a second term, has not shut the door on expansion. But he has expressed concerns about its cost and has said he does not 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 is 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.”
In Missouri, efforts to extend Medicaid coverage fell apart at the end of the legislative session when a near compromise was scuttled by Republicans opposed to expansion. The Missouri Hospital Association and other business groups intend to resume the fight in the fall.