BY: ANNA KAMINSKI AND TIM CARPENTER
Kansas Reflector
Kansas one of 10 states refusing to embrace wider Medicaid eligibility
TOPEKA — Kansas Senate Democrats attempted Tuesday to insert Medicaid expansion into a bill increasing legislative oversight over public assistance programs.
The outcome was the same in the Kansas House when a Democrat sought to drop a Medicaid reform package into a state government budget bill.
Sen. Renee Erickson, a Wichita Republican, brought forth Senate Bill 161, which would require legislative approval for any changes to public assistance programs in Kansas if they seek to expand eligibility, increase costs to the state, request federal waivers or modify intellectual or developmental disability services.
A Democrat from Kansas City, Kansas, Sen. Pat Pettey, took the opportunity during floor debate on the bill to introduce an amendment that would adopt the Healthcare Access for Working Kansans, or HAWK, Act.
Democratic Gov. Laura Kelly and a handful of Democrats in the House and Senate announced in early February the HAWK Act’s introduction into both chambers. It was the governor’s seventh time trying for Medicaid expansion.
The proposal drew support from Democrats and health advocacy groups, but that support was tinged with criticism for a work requirement baked into the act.
It did not receive a hearing this session, Pettey pointed out Tuesday.
“Medicaid expansion is not political,” she said, referencing survey data that shows most Kansans support expansion or widespread access to affordable health care.
Kansas is one of 10 holdout states that have not expanded Medicaid.
“It saves lives,” Pettey said. “It saves Kansans money. It stabilizes rural hospitals. It brings taxpayers’ money back to Kansas.”
Pettey said the state has passed up on more than $8 billion by refusing to expand KanCare, as Medicaid is known in Kansas.
Senate President Ty Masterson, an Andover Republican, pushed back.
“I agree that it is not partisan,” he said, “but there is a whole host of reasons not to do it.”
He acknowledged the lack of discussion on Medicaid expansion this session and encouraged it to take place, rather than block consideration of Pettey’s amendment.
“It’s not like Kansas isn’t getting its money back,” Masterson said. “Kansas is doing the right thing and putting the right people at the front of the line.”
Democrats’ efforts were unsuccessful without the support of a majority of Republicans. Pettey’s amendment failed with 12 in favor — three Republicans and nine Democrats — and 28 Republicans opposed. Republicans who voted in favor were freshman Sen. Mike Argabright of Olpe, Sen. Rick Billinger of Goodland and Sen. Brenda Dietrich of Topeka.
Over in the House
Members of the Kansas House deflected an attempt to insert Medicaid expansion into next year’s state budget bill. The maneuver failed by a wide margin following lengthy debate. It was stopped with a roll call vote of 34-82. Republicans hold an 88-37 majority over Democrats in the House.
Rep. Suzanne Wikle, D-Lawrence, proposed a plan that would extend health coverage to about 150,000 lower-income workers across the state without costing the state treasury.
Under the Affordable Care Act, the federal government must cover 90% of a state’s increased expenditures for Medicaid expansion. Congress adopted a supplemental incentive aimed at Kansas and other holdout states. The additional federal support would mean Kansas could save $78 million on Medicaid in the upcoming fiscal year by approving expansion.
“Budgets are a reflection of your priorities,” Wikle said. “Show me a budget and I’ll show you what you care about.”
Rep. Troy Waymaster, the Bunker Hill Republican who chairs the House Appropriations Committee, acknowledged the financial reality of Wikle’s proposal but urged lawmakers to reject her amendment.
“I recognize there might be some savings, but we need to vote this down,” Waymaster said. “If this were to pass, we’d have Medicaid expansion for one year. That’s it. Unless there is legislation that would pass in subsequent years.”
Rep. Nikki McDonald, D-Olathe, said it was frustrating House GOP leaders had again sought to stifle regular debate on fiscally responsible Medicaid expansion proposals in House committees and on the House floor. She urged rank-and-file Republicans to pressure their GOP leaders to bring about meaningful debate on Medicaid expansion rather than suppress an approach for improving access to affordable health care embraced by 40 states.
House members who didn’t believe it important to extend preventive health care to thousands of Kansans with modest incomes should take a different approach to Medicaid expansion, said Rep. Stephanie Sawyer Clayton, D-Overland Park.
“If you’re not going to vote for this out of a moral reason, you should at least vote for this out of a cold-hearted business decision to make sure that our workforce is as healthy as possible so we can make sure we are working them as much as possible to help our economy,” Sawyer Clayton said.
Senate’s efficiency bill
In the Senate, the underlying bill on government efficiency was passed despite criticism from Democrats.
Sen. Cindy Holscher, an Overland Park Democrat, called the bill “inefficient” and said it added “layers of bureaucracy for even the simplest program changes.”
“That red tape could result in thousands of Kansans being unable to get time-sensitive help,” she said.
When the Legislature is not in session, oversight of public assistance program changes would shift to the Legislative Coordinating Council, which consists of the governor and House and Senate leadership.
More than half a dozen advocacy organizations indicated their opposition to the bill at a hearing before the GOP-led Senate Committee on Government Efficiency, which was created in response to and modeled after the federal initiative under billionaire Elon Musk’s so-called Department of Government Efficiency, which is not actually a federal department. However, Shawnee Republican Sen. Mike Thompson indicated at the hearing the bill could be a solution to complaints over the Kelly administration’s pursuit of changes to intellectual and developmental disabilities programs.
During the hearing and again on the Senate floor, Holscher said the bill could put at risk Kansas’ existing share of Medicaid funds, more than $3 billion for fiscal year 2025. That could be the case if certain federal deadlines, such as those associated with payment rate adjustments, are not met.
Legislators pushed bills through the Senate at a rapid clip Tuesday ahead of a self-imposed deadline Thursday to pass all bills that originated within the chamber. Senators on Tuesday gave first-round approval to more than 40 bills.