The Kansas Hospital Association is working on an alternative to expanding Medicaid under the federal health care overhaul, but Gov. Sam Brownback and other top Republican leaders remained wary as the GOP-dominated Legislature opened its annual session Monday.
Cindy Samuelson, a Kansas Hospital Association vice president, said the group is not yet sure what form the proposal will take. One possible option is using additional federal dollars for Medicaid promised by the 2010 federal health care law to subsidize private health coverage for uninsured Kansans, an approach taken by Arkansas and Iowa.
The association last year hired a firm led by former U.S. Health and Human Services Secretary Mike Leavitt to help draft a proposal for legislators, and the association's board expects to get an update on the work during a regular conference call meeting Tuesday. Leavitt is a former Republican governor of Utah.
Kansas legislators last year voted to prohibit the expansion of Medicaid through June 2015. The state's $3 billion-a-year Medicaid program — known as KanCare — provides health coverage for about 343,000 needy and disabled Kansans.
Advocates for expanding Medicaid argue that it will help tens of thousands of needy Kansans, and the association notes that the federal law cut payments to hospitals elsewhere, anticipating that states would expand Medicaid to offset those changes.
"We're hopeful that we can develop some sort of unique Kansas solution," said Samuleson.
Brownback and most other top Kansas Republicans have been critical of the federal health overhaul, which was championed by President Barack Obama, a Democrat. They've argued that its mandates will drive up insurance costs and hurt the economy, and they've been skeptical that the federal government will keep its promises to finance most of the Medicaid expansion.
The governor said Monday that he's open to new ideas, but his priority remains extending in-home services to disabled Kansans who are on a waiting list. He said he worries that expanding Medicaid — covering additional able-bodied adults — will divert resources from helping the disabled, even if the state picks up only a small share of the costs.
"That'll all come away from people with disabilities," Brownback said during a brief interview. "That's not a moral choice."
House Speaker Ray Merrick, a Stilwell Republican, told reporters during a news conference last week that he's not prepared to move forward with a Medicaid expansion unless the governor endorses it.
In a pre-session interview, Senate President Susan Wagle, a Wichita Republican, pointed to the problems surrounding the rollout in October with a federally run, online insurance marketplace under the health care overhaul as a reason to avoid moving on a Medicaid proposal. She said for the hospital group's plan to be viable, there has to be "a stable, predictable federal environment."
But Senate Minority Leader Anthony Hensley, a Topeka Democrat, said proposals for subsidizing private coverage for additional Kansans are worth considering. Hensley said Brownback wants to avoid the "hot potato" issue to avoid antagonizing tea party-aligned Republicans while trying to tie his Democratic challenger to Obama while seeking re-election this year.
But Brownback replied, "I've been pretty straightforward about this all along. Obamacare continues to, really, just be a wreck."