Will Sen. Jim Denning, longtime foe of Kansas Medicaid expansion, fight for it now?

You know that cliché about the zeal of the newly converted? We’re about to find out whether it applies to Kansas Senate Majority Leader Jim Denning’s new support, after years of opposition, for expanding Medicaid coverage to as many as 150,000 more low-income Kansans.

After nine years of can-kicking on making KanCare available to more of those who need it, the message from Denning’s constituents in increasingly diverse and Democratic Johnson County is pretty close to “get this done or else.”

In an election year, with a serious challenge from Democratic state Rep. Cindy Holsher, the Republican from Overland Park has every reason to stand up for his own Medicaid compromise with Democratic Gov. Laura Kelly.

Then again, even after committing to expansion last spring, Denning personally blocked a last-ditch effort to get legislation out of committee, and said he was in no hurry. “It’s not like they’re not getting health care” meanwhile, he said of those without insurance. And “if we can save a little bit of money and stretch this out, we should.”

He agreed to the deal with Kelly earlier this month, after his own plan for expansion was panned by both parties.

Until Kansas passes the bill, those who earn too much for traditional Medicaid but not enough to buy private insurance will continue to be treated in hospital emergency rooms, where taxpayers pick up the cost anyway. Or they won’t get care at all.

He did argue for the compromise in Topeka last week, telling his fellow Republicans in a hearing that the work requirement some of them are holding out for would never hold up in court. Nor, he said, would a provision allowing health care providers to refuse to provide certain care, such as birth control: “We’re going to get knocked down every time,” he said. “We just took the approach that let’s not waste energy in doing it. It’s just not ever going to happen.”

This whole overdue expansion still may not happen, especially given Senate President Susan Wagle’s opposition, so any ambivalence he’s harboring had better be so invisible it’s immaterial.

At a recent public discussion of Medicaid expansion at the Johnson County Public Policy Council, Denning worried at least a couple of those present by referring to the Medicaid expansion bill as a health care bill, and referring to its work referral provision in it as a Kansas version of a work requirement, which it is not.

Denning’s chief of staff, Ethan Patterson, insists that his boss is definitely “full steam ahead” at this point. “The writing is on the wall as we see it,” he said. (Asked why then Denning looked like he had a toothache while colleagues applauded the compromise during Kelly’s recent State of the State address, he joked that if Denning gives a half-wave, that’s him being effusive, and if he smiles, that’s him giddy with glee. “That’s just Jim. He’s very stoic and reserved.”)

Denning and his long-time conservative ally Wagle not only now disagree on the Medicaid bill, but also have very different electoral pressures and priorities.

She’s running for the U.S. Senate and has always made opposition to abortion rights a defining issue, so is pushing hard for the constitutional amendment that would get around the April Kansas Supreme Court ruling that said the right to an abortion is protected under the state constitution.

Medicaid expansion supporters fear their bill could be “held hostage” to the abortion amendment, and amendment supporters fear the opposite scenario.

Wagle has the power to keep the Medicaid expansion bill Denning needs stuck in committee, while Denning has the power to put the abortion amendment Wagle needs up for a vote or not.

He could also, with 24 votes, override her and pull the bill out of committee, which would have happened last year if he hadn’t voted “present.” But if he did that, it would be in the knowledge that she has the ability to remove Republican members from chairmanships and committee assignments if she wants to.

On the relationship between Wagle and Denning, Patterson laughed and said, “I don’t see much of Susan because she’s running for U.S. Senate.”

“There’s definitely a lack of trust on all sides,” of the two bills, and in the House as well as the Senate. “The larger issue is, we will run the constitutional amendment; that’s never been an issue. We’ll put it on the calendar. But the concern is we’re losing votes because there’s distrust and belief the Medicaid bill will be amended” in ways that would effectively kill it.

“If there was a commitment that there’d be no games in committee to delay or kill Medicaid expansion, there’d be no problem” on the amendment. “There needs to be a trust agreement.”

So, is there any movement in that direction? “I wouldn’t say that discussions have materialized a lot of productive thoughts. … I’m not getting in the way of the abortion amendment, nor would I.”

Yet “everyone is doing their own thing at this point. It’s still early in the session. I think we’ll get there.”

For Denning, this is a matter of political survival, and there’s nothing wrong with that motivation. But for thousands of low-income Kansans, it could be a matter of survival, period.