The REACH Foundation supports KanCare expansion to close the coverage gap for working Kansans and protect the state’s health care workforce and health systems that are the primary source of care for low-income families.

• Nearly 150,000 Kansans sit in a coverage gap without affordable options. Lack of coverage puts workers, hospitals and health care systems at risk. The COVID-19 pandemic has added to the financial stress.
• Expanding KanCare will inject hundreds of millions of dollars into health care systems and the economy, increasing jobs and tax revenue, and providing the state savings.
• To date, 38 states have seized this opportunity because the federal government pays 90% of the cost of expansion. Furthermore, Kansas hospitals have indicated their readiness to help with startup expenses.
• Continuing to decline expansion will not save the state money—it simply gives up the opportunity to strengthen families and the state’s economy.

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

• Kansas faces new financial challenges due to the impact of the COVID-19 pandemic, which has affected families, commerce and communities across the state.
• National data show that COVID-19 has resulted in health, housing and employment hardships – highlighting the importance of economic relief. Studies find programs such as SNAP, TANF, EITC and child-care subsidies can help workers and their families gain their footing during hard times.
• Kansas lawmakers should reform tax policies that disadvantage low- and middle-income families and broaden access to programs that support workers and recovery.

The REACH Foundation supports investments in the state’s public health infrastructure and equitable allocation of public health resources.

• Kansas has long maintained a decentralized public health system that relies heavily on local funding and is governed primarily by an elected board of county commissions.
• This localized approach to public health results in wide variation in resources, staffing and capacity, which impacts counties’ abilities to respond to critical health issues. Furthermore, this funding model has placed Kansas near the bottom nationally for public health funding per capita.
• Given the importance of public health entities in addressing community health, Kansas should assess the state’s public health capacity and readiness to respond to future health needs.

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 COVID-19 pandemic, but provider and patient acceptance of this new mode of delivering care has grown during the current health crisis.
• The federal government eased restrictions on telehealth in the Medicare program. States have relaxed restrictions around provider licensing, online prescribing and written consent. These and other temporary changes have helped to ease longstanding barriers to care, including provider reimbursement, geographic isolation, health condition and other limitations.

• Kansas policy makers should take steps now to extend use of telehealth after the pandemic. Areas for action should include review of state telehealth policies; service and payment parity across all types of insurers; investments in technology access and use; and education and training for providers to ensure effectiveness.

The REACH Foundation supports allocation of state resources to plan and implement voter-approved Medicaid expansion by July 2021.

• Approval of Medicaid expansion by Missouri voters confirmed the public’s support for extending Medicaid eligibility to working-age adults with incomes under 138% of the federal poverty level.
• To meet the terms of the ballot measure, the Administration will need planning and infrastructure support. Resolving MO HealthNet’s Medicaid eligibility system problems will help lay the groundwork for implementation of expansion.
• Dozens of studies have detailed the health and economic benefits of Medicaid expansion, including reductions in uncompensated care and household medical debt, creation of jobs and expansion of tax revenues from the infusion of federal dollars in the state’s health care systems.

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

• Missouri’s tax policies are not set up to provide a dependable revenue flow that allows leaders to meet basic public needs – placing Missouri behind many states in its support for roads, workforce, health and education.
• Disruption of the economy and increased joblessness tied to the COVID-19 pandemic have further weakened the state’s financial health.
• Substantial growth in e-commerce provides a case for Missouri to collect internet sales taxes like other states have done.
• Lawmakers also should examine policies that deprive the state of revenue, such as individual and business income tax deductions that prioritize higher earners over low- and middle-income families who help fuel the state’s economy.

The REACH Foundation supports investments in the state’s public health infrastructure and equitable allocation of public health resources.

• The COVID-19 pandemic has reinforced the importance of a well-organized and -funded public health infrastructure. Missouri’s decentralized approach has produced wide variations in the implementation of a coordinated COVID-19 response.
• Missouri’s localized approach to public health funding needs to be reconsidered. Public health agencies receive a base amount of state funding but depend on grants to sustain operations. This approach has placed Missouri 50^th nationally for public health funding per capita.
• Given the importance of public health entities in addressing community health, Missouri should assess the state’s public health capacity and readiness to respond to future health needs.

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

• Use of telemedicine in the U.S. had been minimal prior to the COVID-19 pandemic, but provider and patient acceptance of this new mode of delivering care has grown during the current health crisis.
• The federal government eased restrictions on telehealth in the Medicare program. States have relaxed restrictions around provider licensing, online prescribing and written consent. These and other temporary changes have helped to ease longstanding barriers to care, including provider reimbursement, geographic isolation, health condition and other limitations.

• Missouri lawmakers should take steps now to extend the use of telehealth after the pandemic. Areas for action should include reviewing telehealth policies to support expanded utilization; investing in technology access and use; and education and training for providers to ensure effectiveness.