Close vote expected on KanCare expansion bill

by Jim McLean, Kansas News Service

Kansas lawmakers are getting ready to do something they have never done before: vote on a Medicaid expansion bill.

For the past three years, conservative Republicans who controlled the Legislature refused to allow a vote on the issue.

Things are different this session due to the ouster of several conservative incumbents by moderate Republican and Democratic challengers.

The House Health and Human Services Committee had three days of hearings on an expansion bill last week and Rep. Dan Hawkins, the Wichita Republican who chairs the panel, has tentatively scheduled the vote for Friday.

An expansion opponent, Hawkins says he expects it to be close.

“Either it wins by one vote or it loses by one vote,” he said.

Expansion supporters have been mounting a last-minute lobbying blitz this week, focusing on a handful of members thought to be on the fence. That includes committee members like Rep. Doug Blex, a first-term Republican from Independence, the southeast Kansas community that lost its hospital in 2015 due to financial problems caused in part by the state’s rejection of Medicaid expansion.

“Either it wins by one vote or it loses by one vote.”

The decision to block expansion has cost health care providers and the Kansas economy approximately $1.7 billion in additional federal funding over the last three years, according to the Kansas Hospital Association.

Blex says he doesn’t want to see more Kansas hospitals close, but he’s concerned about warnings from opponents that expansion could be more expensive than supporters are predicting.

“In most (expansion) states it seems like there have been more applicants than what they anticipated,” he says. “The heart is kind of there (in support), but it’s a pocketbook issue.”

Projections compiled by the governor’s budget office estimate that expansion would increase state costs for the privatized Medicaid program known as KanCare by $33 million in the budget year that begins July 1 and by more than $75 million the following year.

David Jordan, executive director of the Alliance for a Healthy Kansas, says that savings and economic activity generated by expansion would more than cover the state’s share of the cost.

“Expanding KanCare can improve health and create jobs. It is working in 31 other states, let’s bring our money back,” he said Thursday in one of a series of tweets aimed at getting supporters to continue their lobbying efforts.

The bill under consideration would expand KanCare eligibility to more than 300,000 low-income Kansans, those earning up to 138 percent of the federal poverty level, which for an individual is about $16,000 a year.

Opponents, including Gov. Sam Brownback, say it would be foolish for lawmakers to pass an expansion bill given plans by President Donald Trump and the Republican Congress to repeal the Affordable Care Act.

Supporters argue that repeal is far from certain. For evidence, they point to the fact that several Republican governors are lobbying to keep the expansion plans they have implemented.

Jim McLean is managing director of KCUR’s 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.

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