Health care advocates and staff at the REACH Foundation watched with interest voter reaction to last week’s state ballot initiatives that passed in Idaho, Nebraska and Utah calling for expansion of Medicaid. As it turns out, even in these three traditionally “red” states, a significant majority of voters are concerned about people having access to health care.
Why has REACH focused a good portion of our grantmaking and advocacy efforts on advancing Medicaid expansion these past six years? Because Medicaid expansion is consistent with our mission of advancing equity in health care coverage, access and quality for poor and underserved people. And because a growing body of research shows that people living in states that have expanded Medicaid have lower rates of uninsurance, better access to care and better health outcomes.
To demonstrate that the same could be true for Kansans, the REACH Foundation helped support a study of health care access and how our state’s low-income residents have fared when compared to their peers in Indiana and Ohio, both of which have expanded Medicaid.
That study, conducted by the Harvard T.H. Chan School of Public Health, found that Medicaid expansion makes a difference in patients’ ability to get the care they need, cover their health care bills and obtain care for chronic health needs. In comparing health access in Kansas to Ohio, low-income adults in Kansas were more likely to delay care because of the cost, have trouble paying their medical bills and report worse overall health care quality. The results were similar when comparing Kansas to Indiana, although the differences were not as large because of Indiana’s expansion approach, which encompasses health savings accounts and requires premium contributions.
Kansas came close to expanding Medicaid in 2017 when the Legislature passed a bill to expand KanCare that was later vetoed by Gov. Sam Brownback. While the Legislature wasn’t able to repeat that effort in 2018, the actions of voters in Idaho, Nebraska and Utah may give Kansas’s next governor and Legislature a reason to proceed. Kansas is now one of only 13 states that has not yet expanded its Medicaid program. We find ourselves among a shrinking number of states that have declined the opportunity to leverage millions in federal tax dollars to invest in the health and vitality of their people, while 37 other states use our funds to support improved health access and care.
Exit polls conducted during the midterm elections across the country found that health care was a top concern of voters. Kansans have consistently expressed support for Medicaid expansion. It is time that our state’s leaders revisit this opportunity and reclaim the benefits that rightfully belong to Kansans.