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OPINION: Sam Brownback's dodge on Medicaid expansion is a new low

Kansas City Star (MO) - 3/27/2015

March 26--All of a sudden, Gov. Sam Brownback is consumed with compassion for the more than 5,000 disabled Kansans who are pleading for services.

This is new. Brownback didn't give a rip about people with developmental and physical disabilities when he rammed through his massive tax cuts, which benefited wealthy Kansans and rendered the state unable to meet its most basic obligations.

And his administration turned a cold shoulder to the protests of families of people with developmental disabilities when they learned that decisions about their loved ones' well being would be turned over to for-profit managed care companies.

But last week, Susan Mosier, Brownback's acting secretary of the Department of Health and Environment, testified before a legislative committee. She said the administration wouldn't consider expanding Medicaid eligibility for "able-bodied adults" until it had cleared the waiting lists of disabled persons needing mostly non-medical services such as occupational therapy, job training, group home placements and respite care for family members.

In other words, Medicaid expansion is not going to happen. Brownback was just toying with people when he recently hinted he might be leaning toward increasing the state's very low limits to the level called for in the federal Affordable Care Act.

Not only is Brownback going to continue to deny access to affordable health care to about 150,000 low-income Kansans, he is cynical enough to use a long-abused group of disabled persons as his rationale.

Brownback has done many contemptible things since moving into the governor's office in 2011, but this beats all in my book.

The disgraceful neglect of disabled citizens predates the current administration. Kansas has run long waiting lists since at least 2000. But the fiscal contortions Brownback and the Legislature created by passing deep income tax cuts in 2012 and 2013 have diminished hopes of eliminating them.

The state's strategy is to use savings in KanCare, the Medicaid program, to whittle down the waiting lists, Mosier said. But she estimated the state's cost of clearing the waiting lists at $1.15 billion through 2025. That's a lot of savings to wring out of KanCare. And, with Kansas looking at budget deficits well into the future, there's no guarantee the administration won't shift that money to pay for some other pressing need.

The administration is not going to clear the lists. Brownback knows it, Mosier knows it and so do the people who have begged politicians for years to place the needs of disabled Kansans ahead of favors for more fortunate constituents.

"It's hard to see this as anything other than using people on the waiting list to drive a wedge between us and the people wanting Medicaid expansion," said Tom Laing, executive director of InterHab, an advocacy group for developmentally disabled Kansans and their families.

Laing said the community of disabled persons and their advocates strongly supports expanding Medicaid eligibility from Kansas' current threshold, 26 percent of the federal poverty level, to the limit set by Congress, 138 percent of the poverty level.

The higher limit would make health care affordable for the low-paid workers who help disabled citizens with daily tasks like dressing, housekeeping and toileting.

While performing physically demanding work that takes a toll on their health, these workers are paid an average of about $9 an hour. If they are offered health care through their employers, it is costly and may not include family members.

Brownback, the master of deception, is setting up a cruel false choice.

Medicaid expansion would be great for Kansas citizens and for the state's economy. If the governor doesn't want to allow it, he should say so. Instead, he's using disabled citizens as a dodge to deny health care to the working poor.

For shame, Mr. Governor. You have reached a new low.

Reach Barbara Shelly at 816-234-4594 or bshelly@kcstar.com. On Twitter @bshelly.

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