Kansas is one of the only states in the nation that has completely privatized Medicaid services, and like all of Gov. Brownback's policies, it's been a disaster. In January 2017 the federal government refused to certify renewal of the program, calling it “substantively out of compliance with Federal statutes and regulations." Complaints included "a lack of engagement and adversarial communication from the State." This key quote from the article says it all: “We had a system that worked, and we wrecked it.”
This week's landmark series in the Kansas City Star on the Kansas government's lack of transparency included an article on KanCare, claiming, among other things, that clients are expected to sign blank treatment plans.
In response to the well-documented problems with the program, soon-to-be governor (and designer of privatized KanCare) Jeff Colyer decided … to include a work requirement for Medicaid. Now those people who make so little as to be eligible for Medicaid in Kansas – one of the most restrictive states in the nation – and who have children older than six years old - about 12,000 people - will have work requirements and lifetime coverage limits to interfere with their access to care. It appears that the Trump Administration will give Kansas permission to do this.
KIFA is against the imposition of work requirements for Medicaid, for the same reason that we opposed them for TANF: forcing people into low-paying, no-future jobs with no other support (childcare, job training, etc.) does not lift them out of poverty, but instead is another bureaucratic gauntlet that the state will force poor people to go through, to add to their already difficult-enough lives. (And if you think being poor is easy, you should try it some time.)
As people of faith, we are called to stand with and seek justice for people who are poor. Our goal is healthcare for everyone, and Medicaid is an important part of that. We see the moral choice as clear: Medicaid should be expanded and available to everyone who needs it, and not subject to arbitrary limits or bureaucratic requirements.
It makes one wonder: why are the poorest among us always accused of dependency and laziness, while the richest are given tax breaks without any assurance that they will use them productively? As the Star also covered, the state gives economic incentives without even being required to tell us who the state is giving money to or how much is involved. Having money is not in itself a sign of moral uplift, yet the sanctimonious language the Brownback administration puts on work requirements and other restrictions to public assistance does not hide the fact that these are yet another effort to judge and punish poor people – or to use the money for other purposes, such as filling in the budget hole caused by tax cuts.
KIFA strongly supports the expansion of KanCare. We have wasted taxpayer money for years by not doing so, as well as endangering the health and economic well-being of our fellow Kansas. Yet we cannot call for the expansion of Medicaid, on one hand, without acknowledging the damage that the Brownback policies has done to the already-existing program, on the other. These are two parts of a whole: We want expansion, but we want an effective program.
The best outcome would be to repeal the privatization (in whole or in part) and take Medicaid back into public hands. Candidates for office next year should consider running on that platform. Until then, KIFA calls on renewal of the program to be significantly slowed, so that its problems can be thoroughly brought to light and effective legislative oversight can be developed, to rein in a program that is in significant distress.
The lives and well-being of our fellow Kansans depends on it.