Thousands could lose Medicaid in Missouri, Kansas
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Missouri and Kansas are adjusting Medicaid budgets ahead of federal changes expected to cut coverage for thousands of people.
The big picture: New federal rules are expected to reduce Medicaid enrollment.
- Work requirements and more frequent eligibility checks will begin in 2027.
- About 5.3 million people could lose Medicaid nationwide, according to KFF estimates.
Driving the news: State Medicaid budgets are expected to shrink by $664 billion over the next decade because of cuts in last year's GOP budget law, while medical costs are rising and tax collections are lagging.
- Medicaid typically accounts for about 30% of a state's budget, putting pressure on lawmakers to cut spending or find new revenue.
By the numbers: According to the Missouri Budget Project analysis, about 170,000 people in Missouri could lose coverage after the new rules take effect in 2027.
- In Kansas, about 13,000 people could lose coverage, based on REACH Healthcare Foundation research.
State of play: In February of this year, Missouri lawmakers approved $76.7 million in general revenue for Medicaid expansion, the first time state dollars have been used to fund the voter-approved program.
- Last fall, Kansas House Speaker Dan Hawkins said lawmakers would look to cut about $200 million from the state budget, including Medicaid spending.
Zoom in: KC's safety-net hospitals and clinics, which treat patients regardless of ability to pay, rely heavily on Medicaid.
- University Health gets more than half its patient revenue from the program, and Children's Mercy gets about 35% of its patient service revenue from Medicaid.
What they're saying: University Health expects to see far more uninsured patients as Medicaid eligibility changes take effect, a spokesperson tells Axios.
- "People need to understand we will be here," president and CEO Charlie Shields said. "We will help our patients prepare for these changes as we continue to prepare ourselves as well."
Zoom out: States are already making cuts and raising revenue to address Medicaid pressures.
- Idaho approved $22 million in cuts to disability services; Iowa passed a new tax on insurers to cover Medicaid shortfalls; and Colorado is weighing benefit cuts and lower provider payments amid a $1.5 billion gap.
What's next: HHS is supposed to issue an interim final rule on work requirements by June 1, ahead of a Jan. 1, 2027, implementation deadline.