Former Secretary of KDHE under Brownback testifies for Medicaid Expansion
Akash Chougule flew in from Virginia AfP to talk about the horrors of the Medicaid Expansion, and make his case clear to Kansas lawmakers - at least from the position of AfP -
The message was clear, a vote to expand medicaid would be a vote that would bring the wrath of Americans for Prosperity, the pocket lobby of Koch Industries, raining down on lawmakers.
With the appearance of the threat of a money fight, the move to expand medicaid looked to stall in the Kansas State House.
In testimony before the committee, Susan Mosier, head of the Kansas Department of Health & Environment noted that the costs of medicaid expansion could be astronomical, using as part of her numbers a guesswork of unfound potential registrants, as well as an immediate clearance of all disabled Kansans who are currently on a wait list for services.
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Mosier testified that expanding Medicaid to cover more than 150,000 uninsured Kansans would cost the state an additional $2.4 billion from 2016 through 2025. But some lawmakers said her numbers were inflated.
The cost of covering newly eligible Kansans would be $771.4 million over the first 10 years. Mosier factored in what’s called the “woodwork effect,” contending that an estimated 36,000 people who are eligible but do not use the service would seek out coverage because of the publicity of expansion. This would cost the state an estimated $455.2 million.
Those numbers combined make up about half of total Mosier quoted. That’s because she also included the cost of taking disabled Medicaid beneficiaries off the waiting lists for support services, estimated to be almost $1.2 billion over 10 years.
Rep. Susan Concannon, R-Beloit, the committee’s vice chair, objected to Mosier including this figure, calling it disingenuous. The bill does not deal with the waiting lists.
Mosiers response was quick:
The AfP and Mosier made repeated allusions to the fact that medicaid expansion helps only 'able bodied' people and would hurt those who are disabled, pitting disability services in Kansas - which they were free to admit was in a shambles with long waiting lists - against others who fall into a category of 'able bodied'. No commentary was made as to whether or not able bodied individuals included those with mental disabilities.
Mosier's testimony stood at stark contrast with former Brownback head of KDHE who testified the day prior:
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Robert Moser, who until December was the secretary of the Kansas Department of Health and Environment, headlined a long list of Kansans asking legislators Wednesday to expand Medicaid.
In a long-awaited and much-anticipated hearing in the House Health and Human Services Committee, Moser urged legislators to look past dissatisfaction with the federal Affordable Care Act (ACA) and consider the practical implications of continuing to refuse expansion and the federal dollars that come with it.
"Expansion is critical for Kansas," Moser said. "Our providers need it. Our people need it."
The panel, which heard this testimony they day before, found themselves wondering aloud if AfP members - who as Rep. Jim Ward (D-Wichita) pointed out were all from out of state, were aware of the current hospital issues within Kansas.. or if they cared.
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Rep. Jim Ward, D-Wichita, scolded Mosier. “How do you stand there and pit disabled people against the uninsured when you haven’t spent a dollar on the waiting lists?” he said.
Republicans also had concern, contending that Governor Brownback was continuing to move the goal posts.
Concannon (R-Beloit) complained about “mixed messages we get from the administration” on Medicaid expansion. She said Brownback has told lawmakers he’d be willing to consider expansion if they can come up with a plan that covers the costs. But she said now the administration is adding new costs to the mix.
“Now, we’re going to throw in the waiting lists and the woodwork effect. That’s frustrating,” she said.
If a bill were to proceed, it would need to get out of committee today; most observers believe that is unlikely now.
Despite large numbers of advocates and only three opponents (AfP testified twice), House Republicans seem unlikely to incur the wrath of Americans for Prosperity.