Kansas Lawmakers Closer to Approving Expansion of Medicaid 

 Kansas legislators moved closer Thursday to approving an expansion of the state’s Medicaid program to provide health coverage for thousands of non-disabled adults, even though the action could prove largely symbolic.

The state Senate Public Health and Welfare Committee backed a bill that would expand Medicaid coverage to as many as 180,000 adults, most now without insurance. The panel’s voice vote sent the bill to the full Senate for a debate that is expected next week; the House approved the measure with a strong, bipartisan majority last month.

But Republican Gov. Sam Brownback opposes expanding Medicaid as encouraged by former President Barack Obama’s signature health care overhaul. Republicans in Congress plan to repeal the 2010 law championed by Obama, a Democrat, and a proposal from the U.S. House’s GOP leaders that Brownback endorsed Thursday includes a provision blocking a Kansas expansion.

Still, supporters are pressing ahead, arguing that expanding Medicaid now would give Kansas a better claim on a larger share of federal dollars later. Advocates for hospitals, medical groups and the poor have been pushing for an expansion.

“There’s momentum and support for this policy,” said David Jordan, executive director of the Alliance for a Healthy Kansas , a pro-expansion group. “What happens in D.C. happens in D.C.”

The 2010 federal law encouraged states to expand Medicaid by promising that the federal government would pick up far more of the cost than it normally does with Medicaid; the figure is now 90 percent. Thirty-one states, including some led by Republican governors, expanded their programs, but Brownback and many GOP legislators remained wary.

The Kansas program, known as KanCare, provides health coverage for 377,000 poor, disabled and elderly Kansas residents. Non-disabled, childless adults are not eligible; non-disabled parents must earn less than 33 percent of the federal poverty level, or about $6,700 for a single mother with two children.

The bill would make adults under 65 eligible for Medicaid if their household incomes are below 133 percent of the federal poverty level, or $16,000 for an individual and $27,000 for a family of three.

Brownback contends that the Medicaid expansion would emphasize helping able-bodied adults over helping the disabled.

Expansion opponents also have argued the federal government can’t be trusted to keep its funding promises — and congressional Republicans are pushing to end the special funding rate for Medicaid expansions in 2020.

The U.S. House GOP plan says that if states expand their Medicaid programs after March 1, they’re not eligible for the higher funding rate. The Kansas bill ends the expansion program if the higher rate isn’t there.

Brownback and seven other Republican governors sent a letter Thursday to U.S. House Speaker Paul Ryan and U.S. Senate Majority Leader Mitch McConnell, endorsing the House GOP plan. The letter said the Medicaid expansion encouraged by the 2010 law “diverts resources away from the program’s core mission.”

Brownback’s budget staff estimated that Kansas would spend an additional $111 million over two years if it expanded Medicaid, even with the higher federal funding rate. Without the higher rate, its estimate was about $700 million.

“We’re writing checks we can’t cash,” said state Sen. Jake LaTurner, a conservative Pittsburg Republican who opposed the bill. “I think we’re being hasty to not wait and see what happens in Washington.”

Supporters of expanding Medicaid saw their efforts thwarted in previous years by GOP conservatives’ antipathy to Obama’s signature policy. But Kansas voters last year ousted two dozen conservative lawmakers, giving Democrats and moderate Republicans more power and boosting support for expanding Medicaid.

“If you can predict what’s going to happen in Washington, that would be great,” said committee Chairwoman Vicki Schmidt, a moderate Topeka Republican. “But in the meantime, we have to move ahead as a state.”


JOHN HANNA, AP Political Writer and Ricardo Alonso-Zaldivar in Washington contributed to this report.

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