A senate committee in Topeka is deliberating the need to expand Medicaid in Kansas. One idea is to secure health insurance for roughly 140,000 people who now cannot afford it. The other idea is, the state cannot afford the expense.
The Kansas House last March passed, by a solid majority (69-54), a measure to expand Medicaid but Senate President Susan Wagle and majority leader Jim Denning refused to allow the Senate even to debate it.
Topeka and Washington now fund Medicaid providing health coverage for about 400,000 Kansas children, pregnant women, individuals with physical and cognitive disabilities and the elderly; all are poor, some desperately so. Adults with children are eligible, but only if they make less than 38 percent of the federal poverty level —- $9,538 for a family of four. Adults without children aren’t eligible for coverage no matter their income. The Kansas share is approximately $1.3 billion annually. If Kansas expands the program, the federal government would cover 90 percent of the additional costs; the state’s share would be between $34 million and $42 million per year.
The Kansas Hospital Association, administrators, physicians, local business leaders and government officials are among the crowds of advocates for expansion. Without it, they say, many hospitals and clinics will plunge deeper in red ink, or close altogether. Local economies are threatened. Entire regions are at risk, further weakened when citizens are without the means for medical care and communities are without a way to offer it. Rural Kansas is especially vulnerable.
In southeast Kansas, as the news service ProPublica has revealed, the poor can be quickly trapped in a cycle of unpaid medical bills and debtor’s prison.
The cost of expanding Medicaid is pocket change compared with the losses that come without it. The state can’t afford the expense? Legislators have doled out billions in tax breaks for businesses and high-bracket earners, in subsidies for office parks and shopping malls, and in the millions wasted on infamous no-bid contracts of the Brownback years. ($10 million in unused computer equipment comes to mind.)
More than 60 years ago, Kansas joined a battle against recurring epidemics of infantile paralysis (polio) that had crippled or killed thousands of citizens, mostly children. When federal funds for a two-year program dried up, the legislature finished the vaccination program with state funding. We became, with Wisconsin, one of the first states to “self-immunize” against a disease that had terrified the nation for decades. The idea was that no one should go unprotected. At that time, a Republican-dominated legislature and a Democratic governor carried it through.
Republicans and Democrats together had understood one truth in our savage political culture: that in a modern industrial society, all individual effort must be braced by a government that guarantees, at least, opportunities for those who want to work, food for those who would otherwise starve, pensions for the old and medical care for the sick.
Today, though, that sense of public promise seems only a memory left, long ago, to curdle.
The needs in
a sheriff’s request
A recent letter from Jerry Montagne, the McPherson County Sheriff, seeks a modest donation to “provide desperately needed resources for all of Kansas’ Sheriffs and deputies.” Donations, he said, will support continuing education and training for deputies, and push back “effectively against modern crime,” to support safer roads, and so on. A $25 contribution – or more – buys honorary membership in the Kansas Sheriff’s Association.
At base, the letter says county law enforcement needs money. Through the year, letters arrive with requests for donations to many worthy causes, and we try to answer a lot of them with some measure of support. The letter from Sheriff Montagne is a different matter.
Law enforcement is among the chief obligations of local and state governments. How well it is funded is up to local councils, commissions and the legislature. How poorly law enforcement is funded may be gauged in part by the number of letters from officials asking for help.
Nearly every item mentioned in Montagne’s letter reflects some shortfall of investment by those who determine the sheriff’s budget.
It’s doubtful that such letters are hype designed to sweeten the jail’s kitty. Nor is the letter something new, and that’s the problem: Why must law enforcement each year re-start campaigns for citizen donations? It’s an odd contrast against elected officials who are always going on about cutting taxes and budgets. Properly funded, sheriffs would have more time and money for law enforcement. And they could save the investment of time, and money in paper, ink and postage for those donation mailings.