Government & Politics

Medicaid expansion moves forward in Kansas amid federal uncertainty

The Senate Public Health and Welfare Committee advanced a Medicaid expansion proposal on Thursday.
The Senate Public Health and Welfare Committee advanced a Medicaid expansion proposal on Thursday. The Wichita Eagle

Kansas state lawmakers advanced a Medicaid expansion proposal on Thursday even as Congress contemplated a bill that could halt states from expanding the program.

Supporters of expanding KanCare, the state’s privatized Medicaid program, said the debate in Kansas can’t be dictated by Washington. Opponents urged lawmakers to wait until the federal health care debate progresses.

The Senate Public Health and Welfare Committee passed the expansion proposal, House Bill 2044, on a voice vote. The bill now heads to the Senate floor. The committee chairwoman, Sen. Vicki Schmidt, R-Topeka, expects the Senate to debate the bill.

Medicaid is a federal program administered by the states that provides health insurance coverage to disabled and low-income people. The bill passed by the Senate panel would increase income eligibility for the program to 133 percent of the federal poverty line – $24,600 for a family of four.

More than 150,000 people could potentially receive health coverage under Medicaid expansion in Kansas. Expansion would help close the so-called “doughnut hole” – where individuals make too much to qualify for Medicaid, but not enough to receive government subsidies to buy insurance.

Negotiations in Congress

Members of Congress continued to negotiate Thursday over legislation that would significantly change the federal health care law. The bill may take away a provision in current law that provides for the federal government to pay 90 percent of the cost of expansion. States pick up the other 10 percent.

The Kansas bill includes a provision that would phase out Medicaid expansion in Kansas if the federal match for the program falls below 90 percent.

“If you can predict what’s going to happen in Washington, that would be great if we could be sure what’s going to happen. But in the meantime, we have to move ahead as a state,” Schmidt said.

Sen. Jacob LaTurner, R-Pittsburg, voted against the plan. He called on lawmakers to wait before making decisions that could cost the state a lot of money.

“I think we are being hasty to not wait and see what happens in Washington,” LaTurner said.

Sen. Laura Kelly, D-Topeka, said lawmakers have no idea how the debate in Congress will turn out. The Kansas Senate has the votes to pass expansion, she said.

If senators pass the bill without changes, it will go to Gov. Sam Brownback.

“I hope the governor gives the people of Kansas what they want,” Kelly said.

Brownback has opposed in past

The governor has opposed expansion in the past.

He has said expansion must include a work component and not affect the budget. Kansas must also provide services to disabled Kansans on waiting lists before expanding services to able-bodied adults, Brownback’s administration has said, although supporters of expansion call that a false choice.

“I’ll look at whatever they decide to send and whatever the final product looks like,” Brownback said Wednesday.

Efforts to expand Medicaid have been largely blocked in the Legislature until this year.

This fall, voters elected a number of new Democratic and moderate Republican lawmakers, giving a boost to supporters of expansion. The new House speaker, Rep. Ron Ryckman, has also been more open to allowing debate and votes on expansion than the previous speaker, Ray Merrick.

David Jordan, director of the pro-expansion group Alliance for a Healthy Kansas, said legislative changes had played a role in advancing expansion. But he also said support had been building at the community level.

“Kansans are ready for this,” Jordan said.

Jonathan Shorman: 785-296-3006, @jonshorman