January 9, 2013
The Honorable Sam Brownback
Office of the Governor
Capitol, 300 SW 10th Ave., Ste. 241S
Topeka, KS 66612-1590
Dear Governor Brownback:
As a nonprofit, nonpartisan social welfare organization with a membership and offices in all 50 states, AARP’s mission is to help people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole. We seek to help older Americans live long and healthy lives. For AARP’s more than 339,000 members in Kansas, we strongly urge you to expand Medicaid to Kansans with incomes up to 133 percent of the federal poverty line (138 percent with the 5 percent income disregard), as set forth in the Affordable Care Act (ACA).
Medicaid expansion under the ACA will both expand access to health care for people who desperately need it, and save the state money. This issue is particularly important to AARP members who are age 50+ but not yet eligible for Medicare. During this historic economic recession, many of these individuals have lost their jobs and their employer-sponsored insurance coverage. Moreover, while people with incomes from 100-400% of the federal poverty rate will be eligible for the federal tax subsidy to partially offset the cost of their insurance beginning in 2014, without exercising the Medicaid expansion option, Kansas will effectively create a coverage gap in the state for those under 100% of poverty.
AARP is helping older Americans who’ve lost their jobs, are struggling to find new ones and can't get affordable health care. We believe expanding Medicaid will help thousands of 50 to 64-year-olds who’ve lost their jobs or are struggling in jobs without health benefits but don't currently qualify for Medicaid.
Expanding Medicaid will provide coverage for hardworking people who’ve paid in all their lives but are now struggling to make ends meet. In addition, it will give people without insurance access to preventive care that can save lives, and ease dangerous and expensive emergency room overcrowding that hurts all of us.
According to research from AARP’s Public Policy Institute, expanding Medicaid would provide health coverage for an estimated 20,219 uninsured Kansas residents aged 50-64, based on the number of Kansas residents aged 50-64 who were living at or below 138 percent of poverty in 2010. Older adults are particularly vulnerable to deterioration in function and health status if they do not have health coverage, inevitably increasing their need for and use of health and long term care.
In Kansas, according to a recent Urban Institute report, approximately 200,000 uninsured individuals would meet the expansion eligibility requirements in 2014. It is noteworthy that Medicaid enrollment will increase whether or not a state accepts the expansion option. Exchanges and their Navigators are required to conduct outreach and education for all health care coverage programs, including Medicaid, and it is anticipated that some of those currently eligible under existing state Medicaid standards will enroll as a result. Medicaid enrollment may also increase, independent of a state’s expansion decision, as states implement the ACA provisions that simplify the application and eligibility determination processes.
There has been some concern that by increasing the number of individuals who receive Medicaid, the cost to the state will increase dramatically. By choosing to expand Medicaid in Kansas can benefit from the new federal matching rate of 100%, rather than the FY2012 match rate of 56.51 for those newly eligible individuals, should it opt to move forward with expansion beginning in 2014.
Expansion means that these individuals, those who are the most vulnerable and in most need of care, would be afforded coverage while the state would be able to fund the coverage through the increased federal match. It makes fiscal and practical sense to expand Medicaid while ensuring that there are no reductions or cuts to such valuable programs to the most vulnerable and in-need population.
As you consider your options and determine whether to fully expand Medicaid, we urge you to consider what will be in the best interest of all Kansans. We also strongly encourage you to continue to involve and engage consumers as you move forward. AARP Kansas stands ready to work with you. If you have any questions about these comments or would like further clarification, please contact me.