2019 KACAP Policy Priorities
1. Expand KanCare
Expanding eligibility under the KanCare program to the level allowed under the Affordable Care Act is the single policy change that would have the greatest positive impact on the highest number of low-income Kansans. Tens of thousands of Kansans are not getting the health care they need because they do not have insurance coverage. Many could have access to insurance if the state used the provisions of the Affordable Care Act to expand eligibility to Medicaid. Under expansion persons not currently income eligible for Medicaid would be covered if their income was at or below 138 percent of the Federal Poverty Level (FPL). This includes persons who are disabled (now eligible up to 75% FPL), parents (now eligible up to 33% FPL), and able-bodied adults without kids (currently not eligible). As many as 150,000 Kansans would be insured under expansion.
Without health insurance, families are forced to choose between going without care or paying for care that they can’t really afford. Either choice has significant consequences for those families. Families that go without care may have or develop chronic medical conditions that make them unable to maintain employment and may have shorter life expectancies. Families that receive the care they can’t afford to go deeper into debt. Expanding Medicaid not only improves health outcomes by increasing care families receive, but it is also an important tool for reducing poverty.
2. Equip Public Assistance Programs to be More Effective Anti-Poverty Tools
The state’s public assistance programs—programs such as Temporary Assistance to Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps), and KanCare (what Kansas calls its Medicaid program)—are important and valuable resources for low-income Kansans. Often called safety net programs, they can help stabilize poor Kansans who are struggling through crises and difficult circumstances. Stabilization is the primary purpose of these programs, but where possible, Kansas should find ways to equip these programs to reduce poverty.
State policies, however, not only keep these programs from reducing poverty but limit their effectiveness as safety net tools, actually exacerbating poverty. Harsh time limits, strict eligibility rules, and strict work requirements have reduced TANF caseloads dramatically, but have been shown ineffective in producing better employment and earnings outcomes for TANF recipients. These punitive policies were made statutory by the ironically-named HOPE Acts passed in recent years.
Because TANF is funded as a block grant to states, Kansas receives the same amount of money regardless of the number of families who receive cash assistance. As caseloads have dropped, Kansas has been receiving far more TANF funding than it is paying out in cash assistance. A portion of these surplus funds has been used for programs that the state has deemed to be consistent with the purposes of TANF. These programs have typically served special populations and have not been applied to the entire range of TANF-eligible families. Even with these special allocations, the pool of unspent TANF funds continues to grow.
To accomplish the end of strengthening the poverty-fighting aspects of these programs, KACAP supports the following:
A. Repeal the HOPE Act provisions, and resist efforts to extend work requirements and/or time limits on other safety net programs.
B. Use TANF surplus funds on promising programs that have broad applicability and that are focused on not just ameliorating the effects of poverty, but reducing poverty, such as two-generation programs operated by Community Action Agencies.