Kansas Expanding Medicaid

From: Joel M. Eichen (joeleichen_at_yahoo.com)
Date: 03/08/05 

Date: Tue, 08 Mar 2005 06:47:20 -0500

Last updated: March 08. 2005 4:03AM

Kansas Ponders Expansion of Medicaid

By JOHN HANNA
Associated Press Writer
 

   
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Miranda Martin, 9, has her teeth cleaned by preventive dental
assistant Bevie Jean Mitchell at a dental clinic in Topeka, Kan. Feb.
23, 2005. Though state medicaid coverage pays for Miranda's dental
costs, many poor adults like Miranda's mother receive no assistance.
Gov. Kathleen Sebelius is proposing a cigarette tax increase to fund
expanded health care coverage for poor adults in Kansas. (AP
Photo/Charlie Riedel) Height (pixels): 453 Width (pixels): 512
 
While many states consider reducing benefits or overhauling social
programs to save money, Kansas Gov. Kathleen Sebelius wants to expand
medical services for the needy.

Sebelius, a Democrat, has proposed increasing tobacco taxes to finance
an expansion of the state's Medicaid program to cover more poor
adults, making her an unusual example of a governor who wants to spend
more.

Neighboring Missouri illustrates the more typical trend among states
in recent years. There, Republican Gov. Matt Blunt is worried about
escalating Medicaid costs and has proposed cutting services.

"There are a few states still expanding, but over the last several
years, it's been a story of cost containment," said Robin Rudowitz, a
senior associate for the Kaiser Foundation's Commission on Medicaid
and the Uninsured.

Sebelius has proposed adding 30,000 adult Kansans to the Medicaid
program, which already provides medical services to about 263,000
people. Nationally, Medicaid provides services for about 46 million
mostly low-income and disabled Americans. They receive services
through states, but the program is financed by states and the federal
government.

Sebelius' goal is Medicaid coverage for adults at the federal poverty
level, $19,350 for a family of four, instead of the current threshold
of $7,160. Children are eligible for state health coverage if they
live in households with incomes double the federal poverty level.

Expanding benefits for poor adults is the most expensive part of
Sebelius' $50 million plan for reducing the state's uninsured
population. To pay for it, she wants to increase the states' cigarette
tax by 50 cents a pack, to $1.29.

Many members of Kansas' Republican-dominated Legislature oppose
increasing taxes. Others worry about expanding Medicaid when the cost
of existing services are rising. The state's total Medicaid budget has
grown 65 percent in the past five years, to more than $2.55 billion,
according to the Department of Social and Rehabilitation Services.

For Tanya Martin, a 27-year-old Topeka resident, the issues are
personal. Last month, she paid $200 to have a broken tooth pulled,
waiting two years to seek treatment until it began to hurt badly and
caused her face to swell. She didn't have health insurance, so she put
the work off as long as she could stand it.

"If the pain was bearable, I would have held out as long as I could,"
she said.

Meanwhile, states are pursuing different strategies to deal with
burgeoning Medicaid costs.

In Florida, Gov. Jeb Bush has proposed revamping Medicaid to resemble
private managed health care plans. In Tennessee, Gov. Phil Bredesen is
attempting to cut 323,000 from that state's program.

In Iowa, Gov. Tim Vilsack also has suggested a cigarette tax increase.
An Alabama legislator is proposing an expansion of electronic bingo
games to help the struggling Medicaid program.

In Illinois, even with costs rising, legislators are considering a
proposal to extend health coverage to a few thousand working class
families. In Colorado, GOP Gov. Bill Owens and Democratic legislators
are at odds over how much to expand Medicaid with revenues from a
cigarette tax voters approved last year.

One model for Sebelius is Montana, where voters last year approved a
$1-per-pack increase in the cigarette tax. Legislators are considering
proposals to increase rates paid to hospitals and other medical
providers, as well as offer coverage to an additional 6,800 adults and
children.

In Missouri, Blunt opposes raising taxes. Instead, he favors changes
that would drop 89,000 of the state's nearly 1 million recipients from
Medicaid and cut benefits for about 370,000 others. During the past
five years, the state's total Medicaid spending has risen 52 percent,
to more than $5 billion.

"The program has grown beyond the state's ability to pay for it, the
taxpayers' ability to pay for it," said Blunt spokesman Paul Sloca.

In Kansas, some lawmakers have similar worries.

"It's the fastest growing part of our budget right now," said
Republican Rep. Brenda Landwehr, chairwoman of a budget subcommittee
on social services. "I think it would be unwise at this time to expand
our Medicaid program."

But Sebelius and supporters of her plan worry about the uninsured. In
Topeka, they include Laurie Bloomer, a 44-year-old who works part-time
as a grocery store cashier. Her husband, a truck driver, also doesn't
have insurance.

They're still struggling to pay off several thousand dollars in
medical bills, some arising from her medical problems following the
birth of their 5-year-old son, Dakota.

"I need to have some sort of insurance, and I don't know where to get
it," she said. 

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