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Medicaid Expansion Remains Top of REACH Policy Agenda

February 18, 2019

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Legislative sessions are well underway in Kansas and Missouri, and, once again, health advocates, health system and hospital directors, and consumer groups are calling for state lawmakers in Kansas and Missouri to take action to expand Medicaid.

Early in the Kansas legislative session there was some hope for movement on Medicaid expansion given Gov. Laura Kelly’s clear position on expanding KanCare. Rural hospital closures, problems with the state’s Medicaid eligibility system, serious shortages in access to in-patient and outpatient mental health services, and other problems have surfaced repeatedly, but still we hear from senior members of the Kansas Legislature that they oppose expansion despite overwhelming public support.

Two KanCare expansion bills that are nearly identical to the expansion bill that was vetoed by Gov. Sam Brownback in 2017 – HB 2102 and SB 54 – are ready for consideration, but no hearings have been scheduled.

In Missouri, recent troubling reports indicate that approximately 70,000 people, including more than 50,000 children, have been dropped from the state’s Medicaid rolls. The state began automating its verification system last year. People who were identified as ineligible for income or other reasons were sent a letter asking them to provide updated documentation. Those who did not respond or could not prove their eligibility were dropped. State health department officials have cited low unemployment and improvements in verification for the drop in Medicaid beneficiaries, but health system leaders, consumer advocates and policy analysts have raised concerns about the scale of the decline.

Medicaid expansion has topped the REACH Foundation’s list of policy priorities for five years. REACH has supported the work of the Alliance for a Healthy Kansas, Missouri Budget Project, Missouri Health Care for All and other education and advocacy organizations, as well as consumer surveys and studies to gather information on health access and well-being.

The Kansas and Missouri Consumer Health Access Survey, produced by RTI International and supported by the REACH Foundation, Health Forward Foundation, Kansas Health Foundation, Missouri Foundation for Health and United Methodist Health Ministry Fund, found that low-income adults in Kansas and Missouri have high rates of unmet need for medical and mental health services, and had experienced problems with medical bills and medical debt. Roughly 30% of adults in both states reported a mental health diagnosis, substance abuse or addiction, but 22% in Kansas and 35% in Missouri did not get needed care due to cost or lack of coverage.

Arguments by lawmakers that Kansas and Missouri cannot rely on the federal support for expansion no longer hold water, and appear to be grounded more in ideology — not economically based. The REACH Foundation will continue to support research, advocacy and broad-based consumer engagement and use our organization’s “voice” on this issue. The time is now.

About the REACH Policy Priorities

The REACH Foundation invests in the work of advocacy partners and develops an annual policy agenda to guide the foundation’s engagement on state and federal policy issues that present the opportunity to improve access to health coverage and strengthen the health care safety net. These policy priorities are informed by our mission and strategic priorities as well as the insight and expertise of community partners that work at the local, state and federal level to improve health within our region.

Review the 2019 Policy Priorities

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