by Andy Marso, KHI News Service
Kansas lawmakers will reconvene Wednesday at the Statehouse to officially end the 2016 session with the traditional “sine die” ceremony.
Since the dust settled on the frantic few days of the veto session in early May, it’s easier to appreciate the job done by Rep. Dan Hawkins, the Wichita Republican who serves as chairman of the House Health and Human Services Committee.
Hawkins salvaged some substantive public health legislation this year despite challenging circumstances, including a shakeup of his committee membership, turmoil in the Senate health committee and an 11th-hour rules dispute over an anti-abortion provision that threatened to scuttle several health reforms.
Hawkins was the driving force in surmounting those obstacles to pass legislation that:
• Bans tanning salons from serving Kansans under 18.
• Allows Kansas to enter an interstate licensure compact for physicians and other medical providers.
• Requires that acupuncturists be licensed.
• Expands the authority of nurse midwives to operate independently of physicians.
• Allows medical professionals to earn continuing education credits by providing charity care.
To do it, he had to navigate some choppy waters.
Turmoil before session
The challenges for Hawkins began a couple months before the session, when House Speaker Ray Merrick removed three members from his committee because of their support for Medicaid expansion under the federal Affordable Care Act.
The ouster of Rep. Barbara Bollier, a physician, Rep. Don Hill, a pharmacist, and Rep. Susan Concannon, the former director of a regional medical foundation, left the committee without their health-related expertise.
With the Legislature in the middle of a two-year cycle, it also meant Hawkins had three new members to get up to speed on the bills sitting in committee.
About a month into the session, the politics of the ACA struck again, with the removal of Sen. Mary Pilcher-Cook as chairwoman of the Senate Public Health and Welfare Committee after she tried to force a floor vote against Medicaid expansion.
That left the committee led by Sen. Michael O’Donnell, the interim chairman who held the position throughout the session, even after a slim majority of his fellow Senate Republicans signed a petition urging Senate President Susan Wagle to reinstate Pilcher-Cook.
The changes put some health-related legislation in limbo.
The tanning ban was the top initiative this year for the lobbying wing of the American Cancer Society in Kansas. But it faced skepticism from some free-market advocates who wanted a parental-permission exception.
In the waning days of the session, the bill still lacked Senate approval.
Hawkins played hardball, suggesting House members on the health conference committee might withhold their support for Medicaid “step therapy” and welfare restrictions coveted by senators until the tanning ban passed.
After the tanning ban bill gained approval near the end of the session, the American Cancer Society called Hawkins “our champion” on its Facebook page.
Last-minute salvaging
The acupuncture requirements, interstate licensure, midwives changes and charity care provision were bundled in one conference committee “mega-bill” that seemed non-controversial heading into the veto session.
Then the other shoe dropped.
Anti-abortion activists, including Pilcher-Cook, insisted on adding an amendment emphasizing that midwives cannot legally perform abortions, although medical groups said that already was the case.
Inserting that provision meant the bill ran afoul of House rules spearheaded by Rep. John Rubin that stipulated language inserted into conference committee bills had to have passed at least one chamber.
Rubin, one of the House’s most vocal abortion opponents, nonetheless balked at breaking the rule, and the House voted to send the bill back to conference. He eventually softened his opposition, allowing the conference committee report to come up for a vote — although he voted against it in protest of the rules violation.
Hawkins found himself shuttling back and forth between interested parties and calling several conference committee meetings in quick succession with the clock ticking.
Rep. Jim Kelly, a Republican from Independence, nervously watched things unfold. He strongly supported the interstate licensure bill as a way to help his area maintain medical care after the closure of a local hospital.
“When you’re at that point, it would be: They all go or none of them go,” Kelly said. “As it turned out, I think the chairman did a lot of effort there in the last day or two and the package of bills was approved, which I greatly appreciated.”
Getting the word out
In addition to pushing for the tanning ban and the bundle of licensing bills, Hawkins drew praise from disability advocates for forming a subcommittee to review the Brownback administration’s plan to combine Medicaid support services for Kansans with disabilities.
And illness advocacy groups lauded Hawkins’ efforts with the step therapy bill for Medicaid drugs.
Kari Ann Rinker, a lobbyist for the National Multiple Sclerosis Society, said Hawkins “has always been willing to lend an ear and listen.”
Rinker said given the Senate’s push for the step therapy bill, Hawkins was under pressure to rubber stamp it and keep it moving. But he took the time to have hearings to, as Rinker put it, “help get the word out.”
“He wanted to create a level of transparency on the issue,” she said. Then, with the bill in conference committee and the session winding to a close, he held out for more revisions to protect patients.
“The way I saw them dig in on the Senate side, I thought we were sunk when it came to the conference committee process,” she said. “But Rep. Hawkins led the way to build in some patient protections.”
Rep. John Wilson, a Democrat from Lawrence, said he would have preferred that Hawkins also champion Medicaid expansion.
But Hawkins’ legislative accomplishments in an election-year session filled with intraparty conflicts surrounding that issue are a reflection of his ability to foster personal relationships and build consensus under the dome.
“I think a driving factor here is his personality and his work ethic,” Wilson said. “If that’s matched with the right policy idea, then we see the results of that.”
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