Kansas may be surrounded on all sides if Missouri passes Medicaid Expansion on Aug. 4.
With just a narrow margin, Oklahoma residents voted to expand Medicaid during a special election held on June 30. Now, Kansas is surrounded on three sides by state’s that have chosen to expand Medicaid, a public health insurance program for the poor.
Based on the final unofficial count, the ballot issue passed with just over a 6,000-vote margin — less than one full percentage point. No matter how close, a win is a win, and Oklahoma became the 37th state to endorse Medicaid expansion. Their vote, made them the third of four Kansas neighboring states to exercise their option under the Affordable Care Act to expand Medicaid to make it available to individual who earn up to 133% of poverty.
All four of Kansas’ neighbors may be Medicaid Expansion states if Missouri residents pass their expansion ballot issue on Tues., Aug 2.
In 2009, Colorado, a consistently progressive state, initially expanded Medicaid to cover any individual who lived in a household where the income was less than 100% of poverty. That was ahead of the adoption of the Affordable Care Act, which was effective in 2014. They immediately took advantage of the ACA’s opportunity to expand Medicaid to cover households with an income of less than 133% of poverty.
Nebraska residents voted to expand Medicaid in 2018 with the plan going into effect in October 2020. Their two tiered plan includes a work requirement that only allows an individual to stay on Medicaid for two years without obtaining a job or job training.
Medicaid expansion was a key provision of the Affordable Care Act, but a Supreme Court ruling made it optional and left the decision up to each state. Medicaid is a public health insurance program for the poor, with states splitting the cost with the federal government.
Polls show Kansas citizens support the expansion of Medicaid, but so far the measure has not been able to make it through the Republican led senate. Last year, Kansas Gov. Laura Kelly, negotiated a deal that with Republicans to get Medicaid Expansion through the Kansas Senate, where it continued to be struck down. However, the measure was tied to an abortion amendment by the Republican leader of the senate who made it impossible to separate the two. Without the ability to get a “clean” Medicaid Expansion bill through the legislature, Medicaid Expansion failed once again.
In both Oklahoma, Nebraska, and Missouri, citizens took action after years of legislative inaction on health insurance proposals by their Republican led state governments. The citizens of all three states launched initiative petitions to get the measure on the ballot.
Petitions were passed across the state, signed and collected until they had the number of signatures required by law to put the issue to a vote of the citizens. In all, the citizens of five Republican-led states – Nebraska, Oklahoma, Maine, Utah, and Idaho – have been able to expand Medicaid through ballot initiatives.
It’s a process that could likely work in Kansas, but Kansas law does not allow similar citizen-driven initiatives. Seems like something else that needs to change in Kansas.