The first Hays Area Chamber of Commerce legislative coffee of the new year featured five area state legislators, U.S. Rep. Roger Marshall of the First District, and the state director for U.S. Sen. Jerry Moran, Alex Richard.
The seven answered questions from constituents Saturday morning in the Memorial Union Ballroom at Fort Hays State University.
The state representatives were invited to speak first by moderator Sara Wasinger, HACC executive director, followed by the national representatives.
Most of the written questions submitted by the audience overlapped state and federal issues, including potential Medicaid expansion in Kansas, rural healthcare, EPA regulations rollbacks, and federal tariffs on agricultural exports.
A poll conducted last year of the constituents of Rep. Leonard Mastroni (R-La Crosse) in the 117th District showed 73 percent of those residents supporting Medicaid expansion in Kansas.
"With 84 critical access hospitals in the state, 40 to 45 percent are operating in the red, according to new stats I just got," Mastroni said. There are six critical access hospitals in his district.
"I think it's crucial for the hospitals for Medicaid expansion."
There are several related bills in the state legislature.
Last month, Kansas Gov. Laura Kelly (D) and Senate Majority Leader Jim Denning (R-Overland Park) announced a compromise proposal that would expand Medicaid to 150,000 Kansans, a step towards Kelly’s campaign promise to expand Medicaid eligibility.
“This proposal includes elements of my plan, of Senator Denning’s plan, of the 2019 House plan, and of the bipartisan plan that passed both chambers in 2017,” Kelly said.
Sen. Rick Billinger (R-Goodland, called Denning's bill as "much better than the one that was passed in the House last year, which is dead on the floor and has a lot of problems."
"I think there's probably a good chance if they get everything else worked out that there will be a bill," Billinger said. "The bill in the Senate has 22 co-sponsors and it only takes 21 to pass that. I think at some point in time it will happen."
Work on the bill was scheduled to begin this week, but Friday, after an anti-abortion amendment to the Kansas Constitution failed in the House, Senate President Susan Wagle (R-Wichita) sent more than a dozen bills related to Medicaid expansion back to committee.
"We'll see what happens Monday morning," said Rep. Ken Rahjes (R-Agra). "Right now everything is truly fluid."
The federal government would cover 90 percent of the cost to expand Medicaid. The state would pick up the remaining 10 percent.
"We don't know what that cost is. That amount varies anywhere from $40 million to $120 million a year," said Rep. Troy Waymaster (R-Bunker Hill, who is budget chairman for the Kansas House of Representatives and also a member of the bipartisan Special Committee on Medicaid Expansion.
"We just came out of a situation in 2018 where we were fighting a deficit situation every single year when we came back in January.
"We're now in what I would call a state of solvency but we still need to be extremely cautious when we add a particular line item to the budget that we don't know what the cost to the state of Kansas will be," Waymaster cautioned.
New fees on health care providers would help cover the cost under Denning’s plan. If passed, Kansas would become the 37th state to expand Medicare.
Hays' representative Barb Wasinger (R-111th Dist.) emphasized the expansion issue doesn't stand alone.
"We need to rethink what we're doing with hospitals in rural Kansas so we can better meet the needs of rural Kansans," Wasinger said. "The old model is not working.
"It seems like one big issue, but it's many, many complex issues that everyone is trying to work on."
First District Congressman Roger Marshall, a doctor from Great Bend, declared healthcare as an issue "near and dear to my heart."
"I think you have to look at healthcare for the whole of rural America," Marshall said.
"We have hospitals that are underutilized in rural America."
Sitting alongside Marshall, Alex Richard, Olathe, state director for Rep. Jerry Moran (R-KS, nodded his head in agreement.
"You've got empty beds here. You've got capacity here," Marshall pointed out. "I want to do everything I can to make Hays' hospital, Colby's hospital, successful."
Telemedicine helps fill the gap in rural healthcare and Marshall wants to see it used more for mental health and addiction treatments.
Richard also talked about the importance of military veterans in rural areas being able to get medical care in their local communities. Moran is chairman of the Senate Veterans’ Affairs Committee.
"Economically and probably care-wise, that's the best way," Richard said. "If the VA can reimburse you at the Hays hospital or the Salina hospital or wherever, and you can get the benefits that are good, that's going to be more economic and better taxpayer outcomes than having a VA hospital."
The HACC legislative coffee series is sponsored by AT&T and Midwest Energy.