Capitol Watch: Lawmakers in Kansas and Missouri are still cowed by Medicaid expansion

The Missouri General Assembly has adjourned for a weeklong spring break. That brings relief, even if it means we’ll have to wait to see what happens to a House bill that grants protected status to plastic bags, sparing them forever from bans by environmentally minded local governments.

Meanwhile:

Dividing lines

Medicaid expansion was a hot topic in both legislatures this week.

Over two days, a Kansas legislative committee heard testimony on a bill that would clear the way for the governor to work on a Medicaid expansion plan.

Hundreds of persons showed up to support expanding Medicaid eligibility to include adults with incomes up to 138 percent of the federal poverty level. Supporters included Robert Moser, Gov. Sam Brownback’s former secretary of the Department of Health and Environment.

Now a physician at the University of Kansas Hospital, Moser said expansion would be good for the state’s hospitals, its economy and for working Kansans.

Unfortunately, his successor took the opposite view. Susan Mosier, acting secretary of health and environment, said expansion would be too expensive. That’s in part because the administration was committed to clearing the waiting lists of about 5,000 developmentally and physically disabled Kansans who are on hold for support services before expanding its Medicaid rolls, she said.

It would be wrong, Mosier said, to show a preference for “able-bodied adults” over the needs of the disabled.

This may be the most disingenuous assertion heard yet from the Brownback administration. Nobody worried about the needs of disabled Kansans when Brownback strong-armed the Legislature into approving the budget-busting tax cuts that favor certain types of businesses and wealthy taxpayers. And the administration has no grand plan for tackling the waiting lists. To use disabled Kansans as an excuse to deny low-income workers access to health care is the zenith of hypocrisy.

Affordable cow act

Give Kansas credit, though. At least it held a hearing on Medicaid expansion. Missouri hasn’t gotten that far.

About 300 persons milled around the Capitol on Thursday, telling lawmakers to “have the debate.” They briefly delayed the start of Senate business and annoyed legislative leaders but received no assurances of a fair debate, or any debate at all.

While ignoring people asking for health insurance assistance, the Senate busied itself by passing a bill granting state subsidies to cover 70 percent of insurance premiums for some of the state’s dairy farmers.

Sen. Ryan Silvey of Kansas City, North, the only Senate Republican bold enough to openly champion a path toward Medicaid reform and expansion, noted that the insurance subsidy is made possible by the federal farm bill.

While refusing to budge on anything related to Obamacare, he pointed out, his fellow Republicans have no problem assisting “Obamacows.”

United we fall

In its quest to cripple public sector unions in Kansas, the Legislature has managed to create panic among state United Way chapters.

A Senate committee advanced a bill that limits paycheck deductions so that union dues cannot be automatically subtracted. The point is to make dues paying cumbersome and inconvenient and deny unions a reliable revenue flow.

Despite the clear intent, lawmakers were eager to make it look like a higher purpose was at work. The state, they said, shouldn’t be in the business of processing transactions for outside groups.

Just to show how fair they were, they worded the bill so that only deductions required by state or federal laws or belonging to employees’ benefits packages could be automatically taken from paychecks.

But that prohibits automatic deductions to the United Way, which relies heavily on the steady cash flow from employee paychecks. One United Way director called the bill “a kick in the teeth.” We can hear the legislators’ phones ringing now.

The anti-union bill also restricts the items state employees can negotiate in contracts to salaries and wages.

And it creates a conflict of interest by abolishing a board that hears disputes between public sector workers and employers and ceding that task to the state secretary of labor. In other words, a member of the administration would mediate disputes between workers and the administration.

All of these elements reflect vengeful and unwise public policy. But, like other major changes for the worse in Kansas right now, this bill appears to be on the fast track.

This story was originally published March 20, 2015 at 5:46 PM with the headline "Capitol Watch: Lawmakers in Kansas and Missouri are still cowed by Medicaid expansion."