It’s rare that one can: (1) do good in policy terms; (2) do well financially; and (3) morally stand on the side of the angels. Gov. Sam Brownback and the Kansas Legislature had just this opportunity earlier this year, and they blew it.
The state could have expanded health care coverage to at least 160,000 poor or near-poor Kansans by accepting the federal offer to expand Medicaid, which is an integral part of health care reform. In short, this would have been a win-win-win for good health care policy, a stronger economy and the straightforward morality of helping the most vulner-able Kansans.
Unlike conservative governors such as Arizona’s Jan Brewer and Ohio’s John Kasich, Sam Brownback, along with the GOP-controlled Legislature, did not rise to the occasion. Even though the federal government will pay all the costs of expanded Medicaid for the first three years and 90 percent down the line, the Republican governing coalition remained unwilling to believe that government can do any good at all.
Thus, rather than extending health care to all adults with earnings under 138 percent of the federal poverty line (about $15,000), the Kansas Medicaid program will remain among the stingiest in the country, limiting eligibility to adults (parents only) who earn less than 32 percent of the poverty line, an unbelievably low $3,700 a year. The governor and the Legis-lature turned their backs on a program to help the very poorest Kansans at almost no cost to Kansas taxpayers. This is a terrible policy decision, one that leaves 58,000 to 78,000 Kansans out in the cold with no coverage at all.
At the same time, rejecting Medicaid meant that hundreds of millions of dollars would not be available to stimulate the Kansas economy, either in urban areas or rural counties, where Medicaid helps shore up hun-dreds of small hospitals, medical centers and nursing homes.
More generally, with a stagnant state economy, addi-tional and much-needed health care spending would create jobs and boost overall spending. One reputable study, done for the Kansas Hospital Association, estimated that we could gain 4,000 jobs over the next few years.
So that’s a second loss for Kansas — a less robust economy. The negative health and eco-nomic policy implications of refusing Medicaid funds are compounded by the additional perverse effects of requiring Kansas citizens to pay for the improved health care of citizens around the country, while reap-ing no gains for themselves.
That’s right, our federal tax dollars fly away to pay for Medicaid expansion in Cali-fornia, Pennsylvania and New York, among other states. What are we, stupid?
Finally, and most import-ant, not accepting Medicaid funding represents a pro-found moral failure by those responsible for governing. We can count beans and conduct studies until we are blue in the face, but simply put, our governor and Legislature have failed our citizens by turning a blind eye to those most in need.
How are we somehow better off as a state if tens of thousands of our fellow Kansans cannot obtain adequate health care? The state is poorer, its most needy are poorer, and so are we all.
We’re poorer because bad health care policies will cost us more in the long run, because our economy will suffer from less activity, and because ideology has trumped sensible policy-making and, above all, compassion.
Burdett Loomis is a professor of political science at the University of Kansas.