Medicaid Expansion took another step forward in Kansas.
BREAKING: Kansas House gives first-round approval to Medicaid expansion in a 70-54 vote
(story will be updated)https://t.co/vPpvWpD84H #ksleg
— Jonathan Shorman (@jonshorman) March 20, 2019
We know from 2017 that the Kansas House and Senate had a working majority to pass Medicaid Expansion. Then Governor Brownback (R) vetoed the bill and the legislature was a few votes short of overriding the veto.
Recently elected Governor Kelly (D) has made Medicaid Expansion one of her priorities. The governor’s mansion and signature will not be a stopping point of an expansion. The bill still needs to go through the Senate where the Senate majority leader is an opponent and is not under any obligation to schedule a vote.
One of the modifications that passed in the Kansas House last night was a premium requirement. This will make currently insured individuals who are low healthcare spenders worse off.
Waymaster has an amendment that would require Kansas to exit expansion if the federal match rate falls below 90 percent. It also allows KDHE to charge recipients $25 monthly fee, with $100 per family max. #ksleg
— Jonathan Shorman (@jonshorman) March 20, 2019
Right now, a single individual earning precisely 100% +$1 of the Federal Poverty Level pays $21 per month for the benchmark Silver plan with a 94% CSR benefit. A family of four earning $25,600 currently pays $44 for the benchmark Silver plan. These families will pay more in monthly premiums by 20% or 120%. There will be a lower out of pocket expense if they are using a lot of services. Low utilizers who are currently buying on-Exchange plans will be worse off.
This is a value judgement on the probability of a counterfactual. Is a Medicaid expansion that makes some people worse off worth it? In my moral universe, it is as right now, as a single forty year old earning under 100% FPL in Wichita is paying $375 a month for the cheapest plan. The premium is at least three-eighths of this person’s annual income. That plan’s deductible is over half of their annual income. Less than optimal Medicaid Expansion makes these folks far better off.