Fifteen medical-related political action committees registered with the Kansas Governmental Ethics Commission had a total of almost $600,000 cash on hand at the July 24 reporting deadline, and officials from the top PACs said they're still forming the legislative agendas that may inform how they spend that money.
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Representatives of several PACs said that their groups will mull their positions on Medicaid expansion under the federal Affordable Care Act.
The expansion, part of the health reform law known as Obamacare, has been opposed by Gov. Sam Brownback and Republican legislative leaders in Kansas. Twenty-seven states and the District of Columbia have expanded Medicaid, which is paid 100 percent by federal tax dollars in the short-term and 90 percent thereafter.
In Kansas it is estimated that expanding the program could extend health insurance coverage to up to 100,000 people.
The Kansas Hospital Association, which had about $94,000 cash on hand at the end of the last reporting period, has advocated for Medicaid expansion.
But the association did not make its campaign contributions contingent on support of that issue during the primary season. Chad Austin, the group's senior vice president for government relations, says it has no plans to do so in the general election.
“They’re looking at a variety of different factors that play into who they’re going to give a contribution for,” Austin says.
Austin says the hospital association does not coordinate spending with other medically related PACs, but it does "reach out to other associations as it pertains to policy issues."
Thus far other associations have not waded too deep into the politically charged question of Medicaid expansion. But there are signs that some are considering it.
The online health insurance marketplace established as part of the ACA provides subsidies for people with certain income levels to purchase private insurance. But those who would have been covered under Medicaid expansion are not eligible for federal subsidies because they make too little money.
The federal law also proposes to reduce payments to hospitals for treating uninsured patients unable to pay, under the assumption that there would be fewer such patients after the expansion of Medicaid.
Pete Stern, chief executive of the Kansas Independent Pharmacy Service Corp., says that has left gaps in coverage and provider compensation that must be addressed. He said he's not sure if his group's PAC will take an official position on Medicaid expansion.
“It’s pretty obvious the hospital association has, and because of the way reimbursements are hanging with the ACA, I think it’s vital,” Stern says. “Even though we don’t have an official position, we do think it deserves a long, objective look for legislators, not only for the sake of hospitals but also for the sake of making sure we’re looking carefully at filling a gap of coverage.”
The independent pharmacy PAC had about $20,700 in cash on hand at the July 24 deadline.
Leaders of two medical associations with more funds said their groups still are forming their legislative agendas, but Medicaid expansion is on their radars.
With $166,700 in cash, the Kansas Medical Society PAC had the most financial clout of the group.
Jerry Slaughter, president of the medical society, says his group for more than 20 years has supported the principle of all Kansans having access to health insurance.
"We believe that just makes sense," he says.
Slaughter says the state has made strides in doing that for children and the elderly, but the demographic that still needs help is lower-income, working-age adults.
“For a long time we’ve supported the state finding a way to cover that population," Slaughter says. "That’s been a long-standing policy predating the ACA. What we’ve also said is it needs to be done in a way that's fiscally sustainable.”
Slaughter says the group is evaluating whether Medicaid expansion fits the bill.
The Kansas Optometric Association PAC ranked second among medical PACs in cash on hand as of July 24 with $124,800.
Gary Robbins, executive director of the optometric association, says the association's board will discuss Medicaid expansion at an upcoming meeting.
"That’s an issue we’re looking at," Robbins says. "We have not been opposed to it, we’re just wondering where we’ll get the money, like everyone else.”
In Kansas, Medicaid is now a managed care program known as KanCare that's operated by three private insurance companies with state contracts. Though some health care providers have complained about reimbursement problems since the switch to managed care last year, Robbins says his group's members have not had issues.
“With KanCare, we’ve been pleased that we haven’t had as many problems as we anticipated," he says. "They’ve been willing to listen to our concerns.”
Whether or not the group decides to take a position on expanding Medicaid, Robbins says it won't make campaign contributions this cycle contingent on a candidate's position on that issue.
“We will not," Robbins says, "because we haven’t made it an ongoing issue.”
