KanCare Expansion: Why It Matters to Children in Foster Care

By Quinn Ried and Joey Hentzler

Kansas families are stronger when they have health care coverage allowing them to visit the doctor and pay for lifesaving medicines. When families are stronger, fewer kids enter our state’s broken foster care system that too often confuses poverty for neglect. Kansas can support families and improve children’s health by expanding Medicaid. Thirty-seven other states and the District of Columbia have already closed the health care coverage gap in their states. Now, more than ever, is the time to expand Medicaid in the sunflower state.

Medicaid expansion reduces financial and psychological distress for families experiencing poverty, a potential cause of child maltreatment. In the 2020 state fiscal year, 2,115 Kansas children entered foster care due to primary reasons related to neglect and parent/child relationship issues connected to economic stress. These factors are, by far, the largest reason for removal, highlighting the necessity of economic supports for Kansas families. In this way, we know that to reduce instances that cause children to enter the foster care system, Kansas must address the large gaps in the social safety-net and expand Medicaid.

In recent years, the opposite has happened. Kansas drastically cut support for children by creating barriers to anti-poverty programs in addition to failing to expand Medicaid. Research strongly suggests that improving access to supports like TANF cash assistance, SNAP food assistance, Child Care Assistance, and Medicaid would reduce the number of children being removed from their homes.

A comprehensive review by the Kaiser Family Foundation (KFF) of 404 studies found that states that expanded Medicaid experienced significant coverage gains, reductions in uninsured rates, improved access to care, more efficient utilization of services, improved affordability of care, improved financial security, more positive health outcomes, state budget savings, state revenue gains, and more overall economic growth. When Medicaid was expanded to parents, regular preventative care for children increased as families became more familiar with the healthcare system and coverage for regular preventative visits.

Medicaid expansion is associated with a statistically significant decrease in reported cases of neglect for children younger than six. Additionally, the KFF review found that positive effects were particularly large among those in rural areas. Coverage gains in expansion states were larger among vulnerable populations, including children, lesbian, gay, and bisexual adults, the unemployed, low-income workers, justice-involved individuals, homeless individuals, noncitizens, people living in households with mixed immigration status, migrant and seasonal agricultural workers, and early retirees.

More Kansans experiencing poverty or hardship will fall through the cracks, and children will
continue to be removed from their homes at dramatically heightened rates. This failure remains an enormous burden on the system. The Department for Children and Families and other state agencies have begun to reform administrative policy and practices to increase access to eligible Kansans, but these fixes are limited to flexibility constrained by state statute.

Legislative leadership will be required to cut through the politics and expand Medicaid. Will the people of Kansas require such leadership from their elected representatives?

Quinn Ried is a policy research analyst and Joey Hentzler is director of advocacy at Kansas Appleseed