Kansas lawmakers are now a step away from what could be a showdown with Republican Gov. Sam Brownback on the political football issue of Medicaid expansion.
The Senate Public Health and Welfare Committee on Thursday advanced an expansion bill to the full Senate for a vote supporters say will take place Monday.
“Hallelujah,” said Sen. Laura Kelly, a Topeka Democrat, immediately after the committee approved the bill on a voice vote with little debate.
“We finally have enough compassionate, considerate, thoughtful legislators to have had this discussion and to pass this bill out of committee,” Kelly said, referring to legislative leaders elected after the recent defeat of several conservative incumbents by moderate Republicans and Democrats.
Sen. Jake LaTurner, a Pittsburg Republican, voted against advancing the bill, insisting that Kansas lawmakers should wait on the outcome of a vote in the U.S. House of Representatives on a GOP bill to replace the Affordable Care Act. Among other things, the federal bill would prohibit states that haven’t already acted from expanding their Medicaid programs.
Since 2013, 31 states and the District of Columbia have expanded Medicaid eligibility. Kansas and Missouri are among 19 that have not.
“I think Washington is going the opposite direction,” LaTurner said. “They’re going to the right and we’re going to the left it seems. This is an enormous entitlement. We’re writing checks that we can’t cash.”
Several members of the committee disagreed, including Kelly.
“We don’t know what the end result in D.C. is going to be,” she said. “So, I think we’re better to play offense here and get Medicaid expanded in the state and then deal with whatever comes down from D.C.”
David Jordan, the director of a pro-expansion coalition that includes several health provider organizations, said pressing ahead with the bill isn't an exercise in futility.
"I think this is an act of leadership," Jordan said. "This is Kansas legislators taking steps to protect the interests of Kansans."
Expanding eligibility for KanCare, the state’s privatized Medicaid program, would provide health insurance to an additional 150,000 to 180,000 low-income adults.
Currently, KanCare eligibility is limited to children, pregnant women, people with disabilities and seniors in need of long-term care who have exhausted their financial resources. Parents are eligible only if they earn less than a third of the federal poverty level, or about $9,200 annually for a four-person family.
Single adults without children currently are not eligible no matter their income. Expansion would extend eligibility to all Kansans who earn up to 138 percent of the poverty level, or $16,642 annually for an individual and $33,465 for a family of four.
How much expansion will cost the state depends on changes made to the federal health reform law, which currently obligates the federal government to cover no less than 90 percent of the cost of expansion. Under that formula, expansion would cost the state an additional $67.2 million in its first full year, according to state officials.
However, expansion supporters point to estimates compiled by the Kansas Hospital Association that show revenue and budget savings generated by expansion would more than cover the state’s share of the cost.
The House passed the expansion bill 81-44 in late February. If the Senate approves it without changes, it would go to Brownback, who while opposed to expansion has stopped short of saying that he would veto the bill.
Jim McLean is managing director of the Kansas News Service, a collaboration of KCUR, Kansas Public Radio and KMUW covering health, education and politics in Kansas. You can reach him on Twitter @jmcleanks. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to kcur.org.