In coming weeks, our news feeds will be loaded with stories on the Trump administration’s plan to cut hundreds of billions of dollars from the nation’s Medicaid program.
Already, we’ve heard stories about non-U.S. citizens being on the rolls, able-bodied adults not having to work, and — of course — widespread fraud and abuse.
Yadda, yadda, yadda.
Before we go down this road, as Kansans, we need to get a few things straight.
Medicaid and Medicare are not the same thing. Medicare is designed to ensure health care for those of us over 65; Medicaid tries to do the same for the poor, our elders and people with disabilities.
Because Medicaid is underwritten by a mix of state and federal funds, states have a say in how their programs are administered. Since 2012, the Kansas Legislature has balked at taking advantage of federal incentives meant to close post-Obamacare gaps in Medicaid eligibility. Consequently, Kansas’ Medicaid program — known as KanCare — is one of the most restrictive in the nation.
Depending on your politics, you may think this is a good thing. But it doesn’t stop uninsured people from going to the emergency room. Hospitals just won’t be paid for treating them.
Other Kansas-specific facts to consider:
• Childless adults are not eligible for Medicaid.
• A parent caring for children is not eligible for Medicaid if their income exceeds 38% of the “federal poverty level,” which, for a parent with two kids, comes to about $843 a month.
• The kids are most likely eligible, but the parents are not. Still, 70 percent of parents on Medicaid are working. Typically, the remaining 30 percent are either enrolled in a job training program or at home caring for a frail elder or child who should not be left alone.
• Between 30 and 40% of all births are covered by Medicaid. About half of Medicaid recipients in Kansas are children.
• In dire emergencies involving patients who aren’t U.S. citizens — complicated childbirths, for example — doctors and hospitals might be eligible for Medicaid reimbursement. The billing process, however, is ill-defined, restrictive and often not worth the hassle.
In Kansas, Medicaid does not pay for non-emergent care for non-citizens. Other states’ programs are not as restrictive.
In its latest annual report, the Kansas Attorney General’s Office notes that from July 1, 2022, to June 30, 2023, its Medicaid Fraud and Abuse Unit “obtained judgements” for more than $308,000. During the same period, Medicaid spending in Kansas came in around $5.5 billion. That’s not a lot. The unit’s 2024 report isn’t out yet.
Forty percent of Kansas nursing home residents’ stays are covered by Medicaid.
