Dick Works encouraged legislators who will represent Allen County in the Kansas House to take “a hard look” at the state’s refusal to accept Medicaid support from the federal government.
“We’re losing supplemental income,” at the new Allen County Regional Hospital with rejection of the federal revenue, “as well as expansion” of that revenue source, County Counselor Alan Weber said at Tuesday morning’s commission meeting. He estimated ACRH might lose as much as $500,000 a year “from its bottom line.”
The legislators are Kent Thompson, Republican who will represent most of Allen County, and Adam Lusker, Frontenac Democrat, who will represent the eastern tier of the county. Both are filling unexpired terms and will stand for re-election in November.
At Gov. Sam Brownback’s insistence, Kansas rejected the federal government’s offer to pay 100 percent of an Medicaid program for three years and 90 percent beyond that.
Brownback’s rationale was his fear the federal government would renege on Medicaid funding and leave Kansas with the responsibility. In addition to Kansas, 23 other Republican-dominated states turned down the federal assistance.
AN ANALYSIS written by Jim McLean of the editorially independent Kansas Health Institute New Service, pointed out many uninsured Kansans who Congress assumed would get coverage under the health reform law instead were falling into what is being called the “Medicaid gap.”
They make too much money or don’t meet other criteria to qualify for the state’s Medicaid program — KanCare — but don’t earn enough to be eligible for federal tax credits to offset the cost of private insurance through the Affordable Care Act.
Those credits are available only to people with incomes between 100 percent and 400 percent of federal poverty guidelines, $11,490 a year for an individual, $19,530 for a family of three. As many as 85,000 uninsured Kansans fall in the eligibility gap, according to KHI.
These Kansans have incomes of 33 percent or more of the federal poverty threshold — $6,445 for a family of three — but below 100 percent of poverty guidelines.
The ACA was written in 2010 to include a nationwide expansion of Medicaid to cover those earning up to 133 percent of the federal poverty level — $15,282 for an individual and $25,975 for a family of three. But a 2012 U.S. Supreme Court decision that upheld the law noted Medicaid expansion was an option for each state.
An analysis done for the Kansas Hospital Association concluded that expanding Medicaid eligibility starting this year would have injected another $3 billion into the Kansas economy and create 4,000 jobs by 2020.
Rejecting expansion will cost Kansas an estimated $5.3 billion in federal aid through 2022, according to a report by the Kaiser Family Foundation.
WORKS ENCOURAGED the new legislators to resist efforts by bankers to remove a mortgage fee charged by Allen and other counties. The fees generate about $90,000 a year in Allen, or the equivalent of nearly 1 mill of property taxes, he said.
“We’re the lowest entity on the political food chain,” Works said of counties and municipalities, and whenever the Legislature pares a funding source the only recourse is to increase property taxes, or find a way to do without revenue.
Thompson has a firm grasp of that concept, having served 12 years as a county commissioner. He also is in real estate sales, which gives him insight to the mortgage fees, which he said paled in comparison to bank charges made when real estate transactions occurred.
Lusker said he would be reluctant to support funding cuts at the state level, noting, “We have things that we have to do … and the money has to come from somewhere.” Cuts, he added, often “trickle down to tax increases for cities and counties.”
THE NEIGHBORHOOD Revitalization Program has been an issue of late for commissioners after Iola proposed to put all of the city in an NRP zone.
The proposal has split the commission, with Works opposed to expansion of Iola’s zone, Commissioner Jim Talkington in favor. Third commissioner Tom Williams views it with some ambivalence.
Works reiterated that he thinks having all of Iola in a zone is circumvention of the law, in that it originally was passed to encourage improvements in blighted areas or of blighted structures. He also thinks that it could give unfair advantage to new retail ventures, while those in place for years did not receive property tax abatements.
NRP provides 95 percent abatement of property taxes for six years, with them then phased in at 20 percent annually the next four years. Tax abatements are triggered by improvements or new construction of $5,000 or more.
“I understand the unfair competitive advantage,” Thompson said.
Williams said he saw the issue as having two hurdles: One getting around the law and interpretation of “blighted,” and then, if Iola won approval of a citywide zone, looking at the option of putting all of the county in an NRP zone.
Talkington interjected that he viewed improvement within NRP parameters as being revenue positive, that taxing entities weren’t losing anything rather gaining revenue over time.
“I’m all for it in Iola,” Talkington said.
Carl Slaugh, Iola administrator, listened to the conversation before saying the city’s position was that the all-encompassing zone would encourage economic development.
