Kansas and Medicaid: New Evidence on Potential Expansion and Work Requirements.

Issue: Kansas remains one of 17 states that have not expanded Medicaid. In 2017, the Kansas legislature voted to expand Medicaid, but former Governor Sam Brownback vetoed the measure.

Goal: To examine evidence on health care coverage and access among low-income Kansans and to review the potential impact of expanding Medicaid with the possible addition of a work requirement as a condition of eligibility.

Methods: Findings from a telephone survey of 1,000 low-income nonelderly adults in Kansas were compared with data on low-income adults in Ohio and Indiana, both of which expanded Medicaid.

Findings and Conclusions: The uninsured rate among low-income Kansans ages 19 to 64 is 20 percent, significantly higher than rates in Ohio and Indiana. Low-income Kansans also reported comparatively more frequent delays in care because of cost, greater difficulty affording medical bills, and worse health care quality. Survey data show Medicaid expansion is favored by 77 percent of low-income Kansans, and state policymakers have expressed interest in using a Section 1115 waiver for expansion, which would include a work requirement. Our data suggest such a provision would likely have little impact on employment in Kansas, where most potential Medicaid enrollees are disabled or already employed.