Ryann Brooks | Emporia Gazette
November 14, 2023
Gov. Laura Kelly discussed the urgent need for Medicaid expansion, shedding light on the challenges faced by the childcare industry and the broader impact on the state’s workforce and economy during a stop in Emporia on Tuesday morning.
The stop was part of the governor’s statewide Healthy Workers, Healthy Economy tour, which she began last month to rally support for Medicaid expansion ahead of the upcoming legislative session. Speaking with childcare providers and local legislators during a roundtable discussion at the Emporia Child Care Center, Kelly mentioned that Kansas has missed opportunities to expand Medicaid for the past 14 years, leaving $7 billion of state tax money in Washington, D.C. Currently, Kansas is one of only 10 states that have not embraced the initiative.
“I’ve tried five times now to get it, and each time we have offered a proposal tailored to address the concerns and objections, particularly from legislative leadership, expressed during the year,” she said.
Now, Kelly is hoping that the sixth time is the charm when it comes to Medicaid expansion.
“Every state around us has expanded, and that is impacting our state in very negative ways,” the governor said, noting that while Emporia might not notice it much, communities bordering Oklahoma and Nebraska are hemorrhaging employees.
Desiree Streight, a family-based childcare provider and early childhood educator based out of Kingman, said childcare is her family’s sole income. Healthcare affordability is a struggle.
“We were quoted a number of $500 through Marketplace a month ago, and it was more than we could afford with the overhead of keeping the program open,” she said. “If something were more affordable, the deductibles were very high, and so you really don’t want to use your healthcare, because then you’re just going to be in debt.”
Streight mentioned she recently read about a family in the same position, paying $1,500 a month for healthcare while running their childcare business, supporting their child, and paying on their student loans.
“They were teachers who chose to go into the childcare industry, seeing the importance of it,” she said.
The lack of Medicaid expansion has led to a scarcity of resources for the childcare workforce, resulting in burnout, high turnover rates, and challenges in recruiting new staff. Childcare centers, both for-profit and nonprofit, are finding it increasingly difficult to provide essential benefits such as healthcare and are unable to compete with businesses that offer more attractive packages.
Emporia Childcare Center Administrator Deb Crowl said she’s not able to offer benefits to her employees. As a result, most of her employees do not carry health insurance. But if the state expanded Medicaid?
“They could afford [healthcare],” Crowl said. “…Medicaid expansion will help stabilize the childcare workforce and, in turn, contribute to the economic well-being of our community. Having access to high-quality and affordable childcare is essential for the working families of today and an early investment in the next generation of Kansas workers.”
The impact extends beyond the childcare sector, affecting businesses across the state. With employees struggling to secure affordable childcare, businesses are experiencing higher rates of absenteeism and decreased productivity. The inability to find suitable childcare options hampers the state’s ability to attract new businesses and maintain a skilled workforce.
Kelly mentioned that more than 24% of Kansas childcare workers would be eligible for Medicaid if the state were to expand it, closing the eligibility gap. She said Medicaid expansion would also reduce absenteeism by increasing access to preventative and behavioral health screenings, prescriptions, and treatment for chronic conditions. Employees are more likely to miss work when they are not healthy.
Sen. Jeff Longbine and Rep. Mark Schreiber, both longtime supporters of expansion, said they have seen little-to-no evidence of able-bodied Kansans not working as a way to get benefits from the state.
“I haven’t seen any evidence of it, but I do see people who work in food service or who are the clerk at your gas station or those jobs that are not being covered, but those that are critical of Medicaid expansion are also complaining about the cost of food and those types of things,” Longbine said. “…When you get an individual that ends up with medical bankruptcy, that affects their ability to buy a house, or even nowadays, to rent a decent place. And so we’re just constantly chasing our tail, of which Medicaid expansion would fix a lot of that. It’s frustrating.”
Schreiber agreed, noting that people that fall into the coverage gap are working.
“They just can’t earn enough or have the capability enough to go to another business that provides company insurance and earns a bigger way,” she said. “I’ve heard the anecdotes, but I’ve not seen the data that these people are all waiting for free medical care.”
The conversation also touched on the efforts made by some communities to address the childcare shortage, including grants for operational expenses and the creation of a 24-hour, seven-days-a-week daycare center. These initiatives aim to fill the childcare gaps, especially for second and third-shift workers, and highlight the importance of public-private partnerships in resolving the crisis.
Kelly said Kansans need to let their legislators know how important Medicaid expansion is if they want to see it happen.
“Communities need to really rally and work with their legislators, letting their legislators know how important this is to their community,” she said. “And then, [they need to] support legislators’ efforts to get legislative leadership to allow for debate and vote on Medicaid expansion during the next legislative session.”