Opponents of allowing a federal expansion of Medicaid in Kansas argue that, even though the federal government would pay the full cost of expansion for the first three years, it would increase state costs. One of the main reasons for that is the “woodwork effect,” in which publicity and outreach about expansion would draw out people who were already eligible for Medicaid or other programs but hadn’t signed up. But that happened anyway. The number of people on KanCare – the state’s privatized Medicaid program – increased about 7.5 percent, from 396,374 people in April 2013 to 426,360 this past April. State officials attribute the increase to the woodwork effect caused by the implementation of the Affordable Care Act nationwide. So Kansas has higher costs but no federal money for expanding Medicaid, estimated at about $820 million over the next three years. That’s a lose-lose for the state budget.
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