Our Policy Agendas for Kansas and Missouri

KANSAS POLICY AGENDA

To achieve the foundation’s mission, we believe it is essential to invest in advocacy and public policy activities and to engage more directly as an organization on specific state and federal policy issues that present the opportunity to improve access to health coverage and strengthen the health care safety net.

KanCare Expansion

The REACH Foundation supports expanding KanCare to provide coverage for 150,000 Kansans and sustain the healthcare workforce and health systems which are the primary source of care for low-income families.

Kansas is one of only 10 states that have declined to leverage substantial federal resources to provide coverage to low-income adults and families.
Kansas spends more per capita on Medicaid than expansion and non-expansion states even with managed care because the Legislature has declined available federal support.
Medicaid eligibility in Kansas is among the strictest in the country, creating a dilemma for Kansans – delaying care for physical and behavioral issues, or accumulating medical debt.
Kansans have expressed their readiness for a solution. Numerous polls show consumers and voters support expanding coverage to help workers and families – and want to see lawmakers answer this need.

Resources:

Alliance for a Healthy Kansas

“The Unexpected Costs of Not Expanding Medicaid in Kansas,” University of Kansas Institute for Policy & Social Research

“New Survey Shows Statewide Bipartisan Support for KanCare Expansion,” Alliance for a Healthy Kansas, 2002

Public Health Infrastructure

The REACH Foundation supports an effective and adequately funded public health system to protect the health of Kansas communities.

Kansas has long maintained a decentralized public health system that relies heavily on local funding, a model that results in wide variation in resources that may not match community needs.
Public health workforce capacity should be studied and rebuilt for the future. Health departments lost experienced staff during the pandemic, which has strained capacity statewide.
Public health priorities should include improvements in health data reporting and monitoring, attention to significant health disparities such as in Black maternal health and birth outcomes, language accessibility, and childhood immunization rates.

Resources:

Kansas Public Health Collaborative

“Reasons for Turnover of Kansas Public Health Officials during the COVID-19 Pandemic.” Int. J. Environ. Res. Public Health 2022

Expanded Use of Telehealth

The REACH Foundation supports expanded use of telehealth to increase access to health, mental health and behavioral health services for rural and other underserved populations.

Acceptance of telehealth has increased among patients and providers. Short-term easing of restrictions on telehealth during the pandemic reduced barriers to care, such as uneven distribution of providers, transportation and travel distance to appointments, and employment challenges that make it difficult to access a provider.
Studies of consumer and provider experience conducted in 2021 and 2022 pinpointed areas of satisfaction and opportunities for improvement, such as reliable broadband, health information technology support and integration of interpretation services to improve care.
Available research should be used to options for strengthening telehealth use. Kansas policy makers should update current laws to respond to changes in health care and address health provider and payor responsibilities.

Resources:

“Telehealth in Kansas During COVID-19: Provider and Patient Experience,” Research Brief, United Methodist Health Ministry Fund and REACH Healthcare FoundationNew Survey Shows Statewide Bipartisan Support for KanCare Expansion,” Alliance for a Healthy Kansas, 2002

Sound Fiscal Policy

The REACH Foundation supports budget and tax policies that ensure revenue is available to invest in core health and social services that enable workers to be productive and families to thrive.

Kansas continues to face health, employment and economic challenges even in the aftermath of the pandemic. Although fewer families are living in poverty than a decade ago, an estimated 89,000 Kansas children live in households with incomes below the poverty line.
Kansas policy makers should revisit provisions in the HOPE (Hope, Opportunity and Prosperity for Everyone) Act to increase access to economic support programs that bolster household stability. These include expanding eligibility for cash assistance to match the federal allowance, and offering new mothers flexibility on work requirements in the cash assistance program for 12 months after giving birth.
Taking action this session to adjust a statute that uses an outdated poverty measure to set income thresholds for the Children’s Health Insurance Program (CHIP) would help qualifying children maintain essential health coverage.

Resources:

Kansas Action for Children

“Income Support Program Lifts Families Out of Poverty,” Kansas Action for Children, August 2022“New Survey Shows Statewide Bipartisan Support for KanCare Expansion,” Alliance for a Healthy Kansas, 2002

Voter Rights & Engagement

The REACH Foundation supports voting protection measures that provide transparent, safe and accessible pathways for voter participation in electoral processes.

National health organizations and provider groups, such as the American Medical Association, have identified voter engagement as an important contributor to individual and community health.
Policy makers should ensure that voting is accessible to all Kansans. Procedures for voter registration and voting should be transparent, convenient and broadly accessible.
As population composition and density changes across the state, policy makers should protect access to early voting and absentee voting, ballot drop boxes, and other measures that provide options for those who work or have other limitations.
One measure to increase voter participation is automatic voter registration, a measure adopted by 22 states and the District of Columbia.

Resources:

The Voter Network

ACLU of Kansas

MISSOURI POLICY AGENDA

REACH supports the work of our Missouri 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.

Stronger State Medicaid Program

The REACH Foundation supports timely and efficient processes for qualifying Missourians for Medicaid to provide health coverage to all eligible adults and children.

Given the economic advantages of a healthy workforce, it is imperative health officials continue to modernize the state’s Medicaid application and renewal processes to reduce unnecessary gaps in coverage.
Missouri will be required to adopt 12 months of continuous coverage for children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) up to age 19 based on a federal provision that goes into effect in January 2024. To further strengthen child health, Missouri should take additional actions to keep children covered, such as extending continuous eligibility beyond 12 months and reviewing the premium structure for CHIP, as other states have done.
Missouri ranks poorly for maternal mortality, with nearly half of deaths occurring between 43 days and one year after giving birth. In addition to ensuring all Medicaid-eligible women are enrolled in coverage, policymakers need to increase support for treatment for mental health and substance use, cardiovascular conditions, and other documented causes of maternal death.

Resources:

Streamlining Medicaid Enrollment Supports Coverage and Reduces Administrative Burdens, Missouri Budget Project, October 2022

Medicaid Postpartum Coverage Extension Tracker, Kaiser Family Foundation, Dec 08, 2022

Sound Fiscal Policy

The REACH Foundation supports budget and tax policies that ensure revenue is available to invest in core services and programs that are demonstrated to help workers and families thrive.

Missouri’s tax policies and budgeting practices have not met funding needs for essential public services. Missouri ranks 48th nationally in the amount of state revenue it collects per capita and 45th in the amount it spends. As a result, Missouri lags neighboring states in investments in roads, education, child and adult health and more.
Missouri leaders should use federal resources to strengthen economic security programs, such as Temporary Assistance to Needy Families, nutrition assistance and other public benefits that can lift families out of poverty.
Policy makers need to assess the impact of the state’s overall tax structure, which favors corporations, to implement policies that bolster low-wage workers and their families. Missouri’s corporate income tax is already one of the lowest – only one state has a corporate income tax rate lower than Missouri’s at 4%.

Resources:

Missouri Budget Project

Kids Win Missouri

Public Health Infrastructure

The REACH Foundation supports an effective and adequately funded public health system to protect the health of Missouri communities.

Missouri’s public health system has been under-resourced for decades, harming health, disease prevention, and life expectancy.
The state’s approach to funding public health needs re-examination. Public health units receive a base amount of state dollars but rely on federal and local grants to sustain operations. This approach places Missouri nearly last among states in per capita funding for public health.
Public health priorities should include improvements in the quality and accuracy of health data collection and monitoring, staff development and capacity building, emergency response preparation, attention to health disparities such as in Black maternal health and birth outcomes, and improving immunization rates.

Resources:

Acosta, Alexis; Benoit, Marie-Anais; Conway, Ciara; Hughes, Dora; Levi, Jeffrey; Markus, Anne; Regenstein, Marsha; Seyoum, Semret; Trott, Jennifer; and Van Bronkhorst, Hope, “Missouri’s Public Health Response to COVID-19: Key Findings and Recommendations for State Action and Investment” (2021). Health Policy and Management Issue Briefs. Paper 61.

Expanded Use of Telehealth

The REACH Foundation supports expanded use of telehealth to increase access to health, mental health and behavioral health services for rural and other underserved populations.

Use of telemedicine in the U.S. had been minimal prior to the pandemic, but provider and patient acceptance of this mode of delivering care grew during the health crisis. Health care workforce shortages, particularly in the areas of mental and behavioral health, support the case for strengthening use of telehealth.
Policymakers should continue to work to increase broadband access, define provider and payor responsibilities, and incorporate telehealth into the state’s covered Medicaid services.

Resources:

JoAnn Volk et al., States’ Actions to Expand Telemedicine Access During COVID-19 and Future Policy Considerations (Commonwealth Fund, June 2021). https://doi.org/10.26099/r95z-bs17

Voter Rights & Engagement

The REACH Foundation supports voting protection measures that provide transparent, safe and accessible pathways for voter participation in electoral processes.

National health organizations and provider groups, such as the American Medical Association, have identified voter engagement as an important contributor to individual and community health.
Policy makers should ensure voting is accessible to all Missourians. Rules and procedures for voter registration and voting requirements should be transparent, convenient and broadly accessible.
Missouri policy makers should eliminate barriers to securing a state I.D., and support community organizations that assist with voter registration.
To strengthen voter participation, Missouri should consider adoption of automatic voter registration, a measure adopted by 22 states and the District of Columbia.

Resources:

Missouri Organizing and Voter Engagement Collaborative (MOVE)

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