New estimate predicts Medicaid expansion would serve 152K at no cost to state

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A $509M federal incentive would help offset state cost for first eight years

TOPEKA — The Kansas Health Institute on Thursday unveiled its analysis of Gov. Laura Kelly’s proposal to expand Medicaid, predicting 152,000 Kansans would enroll in the first year with no additional cost to the state government.

The Democratic governor has made passage of Medicaid expansion a top legislative priority this year, following her statewide campaign to promote the policy last fall. But Republican leadership in the Legislature opposes the policy and has blocked hearings on Medicaid expansion for four years.

KHI, a Topeka-based nonpartisan research organization, announced its new estimates during an online video briefing. The organization plans to publish a full report later this month.

Kari Bruffett, president and CEO of KHI, said rather than focus on the reasons why some people support or oppose Medicaid expansion, the organization was working “to help build understanding” and allow people “to use the same set of facts and numbers for the discussion.”

“We acknowledge that definitely the discussion and debate around Medicaid expansion has evolved over the last decade,” Bruffett said. “And so there’s different questions that are being raised and we try to help address those.”

Kansas is one of 10 states that haven’t expanded Medicaid since President Barack Obama signed the Affordable Care Act in 2010.

The state-run version of Medicaid, called KanCare, provides health care services to low-income families, seniors and people with disabilities. Currently, those who earn less than 38% of the federal poverty level are eligible. For a family of four, the annual income limit is $11,400.

Under the ACA, also known as Obamacare, the federal government offers to cover 90% of the cost of Medicaid services in exchange for expanding eligibility to 138% of the federal poverty rate. The annual income threshold for a family of four would be $41,400.

Kelly’s proposal includes a work requirement with exceptions for full-time students, veterans, caregivers, people with partial disabilities, and former foster kids. Her plan also would add a new surcharge for hospitals.

KHI predicts the change in income eligibility would result in 151,898 people enrolling in KanCare — 106,450 adults and 45,448 children. Those numbers include 68,236 adults and 16,377 children who are currently uninsured.

About 68.9% of the adults are already working at least part-time, according to the KHI analysis. It isn’t clear how many of the remaining 31.1% would be excluded under Kelly’s work requirement, but KHI determined 19.1% of the unemployed adults have a disability, 16.1% are students and 3.8% are veterans.

KHI calculated the cost to the state for expanding Medicaid over the first eight years would be fully offset — mostly because of a $509 million incentive included in the American Rescue Plan Act of 2021. Other savings would come from the federal government picking up more of the tab on existing services, as well as the new surcharge on hospitals.

Support for Medicaid expansion

The Kansas Sunflower Foundation on Thursday released findings from two surveys conducted in November that show broad support for Medicaid expansion.

The surveys found that 68% of Kansas voters, including 51% of Republicans, and 83% of small business owners support Medicaid expansion.


Steve Baccus, an Ottawa County farmer and former president of Kansas Farm Bureau, said in a news release announcing the poll results that expanding Medicaid was about “investing in the well-being of our communities.”

“Our rural communities are often struggling to keep Main Street open and to continue to offer the necessary services to the surrounding agricultural enterprises,” Baccus said. “A community that can offer a total health care package has an advantage in maintaining a viable town.”

The Sunflower Foundation works to improve the health and well-being of all Kansans.

The surveys were conducted by Public Opinion Strategies. The survey of 500 voters was conducted online and has a 5% margin of error. The survey of 107 owners of businesses with fewer than 500 employees was conducted by phone and online and has a 10% margin of error.

The findings are consistent with a Fort Hays State University poll that was released in October.

Kansas Reflector is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Kansas Reflector maintains editorial independence. Contact Editor Sherman Smith for questions: Follow Kansas Reflector on Facebook and Twitter.

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