Gov. Laura Kelly will allow junk insurance. Now, will Kansas GOP expand Medicaid?

Could Medicaid expansion save Kansas’ rural hospitals?

Kansas is one of 14 states that has yet to expand Medicaid, something proponents say could be part of the solution for rural health care.
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Kansas is one of 14 states that has yet to expand Medicaid, something proponents say could be part of the solution for rural health care.

Kansas Gov. Laura Kelly has already gotten more done in her first year in office than many thought she could, given GOP opposition to virtually everything she ran on.

Hopefully, the Democratic governor’s decision not to veto legislation that will allow Kansans to buy completely unregulated health plans — also known as junk insurance — will pay off, too.

She’s arguing that in return, Republicans should let Medicaid expansion at least be debated.

“New ideas always carry a certain level of risk,” she said in a statement announcing her decision to let the Kansas Farm Bureau-backed bill become law without her signature. “I believe the potential risks of this legislation can be mitigated if they are coupled with a stable, secure, proven health care option: Medicaid expansion.”

Cut-rate plans are not a new idea, though the Farm Bureau can claim that because not all of the specifics are known. But this legislation does carry a high level of risk because such trade association health plans don’t necessarily include all of the coverage required under the Affordable Care Act. Nor will they be subject to any state rules under the Kansas Insurance Department. The plans will avoid state regulation because the law declares that it’s not insurance at all, and on that we agree.

Right after Kelly announced that she would let the bill become law, the Kansas Farm Bureau returned the favor by calling Kelly’s health plan, which of course does include the desperately needed Medicaid expansion, a “critical piece” of the health care whole. “Today Governor Kelly made a personally difficult choice in the spirit of compromise. By refusing to succumb to political obstructionism, she has paved the way for lawmakers to advance a comprehensive health care solution that will benefit our entire state,” Farm Bureau President Rich Felts said.

The Farm Bureau won’t be voting on Medicaid expansion, though. And there’s no evidence that Kelly has a deal with the GOP lawmakers who will be, and she still seems to be several votes short of the number required to force a debate.

But then, since the ag lobby’s legislation passed with veto-proof majorities in both the House and Senate, Kelly had little to lose with this Holy Week Hail Mary.

By letting it go through, despite her “serious reservations,” she can point to it as a “demonstration of my genuine commitment to compromise.”

In her statement praising the law, Republican Senate President Susan Wagle didn’t so much as nod at Kelly — or at Medicaid expansion. “I commend the Kansas Farm Bureau for working to find an affordable alternative especially one that won’t fall under the disaster of Obamacare.”

It’s affordable because it won’t fall under the non-disaster of the Affordable Care Act requirement that all plans cover those with preexisting conditions. The unregulated plans won’t necessarily have to cover maternity care, mental health and addiction services or prescription drugs, either.

It’s true that premiums are high, and the Farm Bureau says many of its members don’t qualify for subsidies. But costs are what have to come down, and cutting coverage in the way this bill allows only works for people who don’t get sick. That’s why only two other states have allowed plans like this.

We agree with the bill’s opponents — the American Cancer Society, American Lung Association and the private insurance companies that will not be able to compete with these anything-goes plans. Then what?

The Kansas Senate will vote May 1 on whether to move Medicaid expansion, which passed in the House last month, one step closer to debate. Let’s hope that GOP Senate leaders decide in the interim that providing more uninsured Kansans with real health care and helping rural hospitals stay afloat are more important than the intransigence that they seem to think will impress GOP primary voters in next year’s Senate race.

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