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Why Kansas Democrats Shied Away From Medicaid Expansion Issue

Post-election soul-searching by Kansas Democrats includes disagreement over whether Medicaid expansion should have been a larger part of the party’s strategy.

The Democrats lost all statewide races for the second straight time and lost another five House seats to drop their number in that chamber to 27. The defeats were part of a national wave of Republican election wins, but they have nonetheless led to talk within the Kansas Democratic Party about what could have been done differently.

At the top of the ticket, Democratic gubernatorial candidate Paul Davis focused his campaign almost exclusively on school funding, in an attempt to woo moderate Republicans. After leading in polls for months, Davis ultimately fell a few percentage points short of defeating incumbent Gov. Sam Brownback.

Joan Wagnon, chairwoman of the Kansas Democratic Party, says polling didn’t indicate the Medicaid expansion issue was much of a difference-maker with voters. So, the party left it up to individual candidates to decide whether to use the issue in their campaigns.

“There was a lot of discussion about the issue, but no strategy, per se,” Wagnon says. “Democrats feel strongly about that issue and felt like it should have been expanded, but Republicans didn’t see it in quite the same way. So it wasn’t an issue that would make headway for us, so to speak.”

Twenty-seven states and the District of Columbia have expanded Medicaid eligibility, while Kansas and 20 other states have not. Policymakers in two states are considering the issue, according to the nonpartisan Kaiser Family Foundation.

A poll released last year by the Kansas Hospital Association, which favors Medicaid expansion, found that 60 percent of polled Kansans supported it.

But the KHA poll never mentioned that Medicaid expansion is part of the federal Affordable Care Act, also known as “Obamacare,” and Wagnon says that makes a difference when it comes to public opinion.

“You have to understand the issue, and it’s a hard issue to talk about and explain,” Wagnon says. “What the Republicans did was they said, ‘Well, this is just Obamacare.’ When they tag an issue like that with some scary words to try to increase the negative feelings, then it’s harder to have a discussion.”

Ryon Carey, a political consultant in Lindsborg and chairman of the Democratic Party’s lesbian, gay, bisexual and transgender caucus, says that rather than avoiding the Affordable Care Act, the party should have attempted to explain its benefits to voters.

“Obama’s still president and the Medicaid expansion was enacted under Obamacare, so of course they’re going to scream ‘Obamacare,’” Carey says of the Republicans. “It would have been nice if Democrats would have actually stood up for their signature legislation in 60 years rather than running away from it. (President Harry) Truman would not have run from Medicaid expansion.”

Wagnon said Davis express support for expansion when asked about it, and Dennis Anderson, the Democrats’ unsuccessful candidate for Kansas insurance commissioner, took a strong position in favor of it.

Down the ticket, Democratic House candidates were left to decide how the issue would play in their particular races.

Former representative Ann Mah, unsuccessful in her attempt to retake her Topeka seat from Republican Ken Corbet, said she didn’t make Medicaid expansion part of her campaign, though she supports it.

“The Legislature had painted the Medicaid expansion issue with such a broad brush,” Mah says. “People, they just say, ‘Obamacare bad.’”

Nancy Lusk, a Democratic House member from Johnson County who was re-elected, says she declined to campaign on Medicaid expansion because she had limited time to try to get her message across while going door-to-door. Lusk says she chose instead to focus on the state’s impending budget crisis.

Mah says that also was the focus of her door-knocking visits. At the thousands of homes she visited, Mah says only a few people wanted to discuss Medicaid expansion.

“Those were medical professionals who knew we needed it and weren’t getting it,” Mah says. “Or they were hospital employees and their hospitals were really taking a hit.”

In Kansas, Medicaid expansion would extend coverage to an estimated 151,000 people with annual incomes up to 138 percent of the federal poverty level – about $16,100 for individuals and $32,900 for a family of four.

Increasing Medicaid coverage would decrease the amount of uncompensated care Kansas hospitals must perform each year.

Julie Menghini, a Democratic House member from Pittsburg, says she campaigned on Medicaid expansion, sending out two or three mailers on the issue in part because she knew that hospitals “really, really need to see it happen.”

Menghini says polling in her district suggested the issue would not be “a huge win” for her, but it “wasn’t going to be a negative either.” She narrowly lost to Republican Chuck Smith, a well-known high school football coach, but says she did not think Medicaid expansion was a factor.

“Frankly, my race didn’t end up being about issues,” Menghini says. “It ended up being about who can say the craziest, meanest thing about me and get people to believe it.”

Jim Ward, a Wichita Democrat who has expressed interest in replacing Davis as House Minority Leader, says Democrats used Medicaid expansion as an issue in the election, but “clearly not enough.”

“Candidates I talked to were encouraged to use it,” Ward says. “I think it still is a very potent issue.”

Ward says the tide is turning in favor of expansion as more Kansans hear the practical arguments for it and grow weary of the ideological arguments against it.

“The ‘This is just Obamacare by another name’ (argument), it doesn’t work,” Ward says. “People see the dollars and cents, and the opponents’ arguments are shallow. More and more people nod their head when I start talking Medicaid expansion.”

Wagnon says the need for expansion is increasing, both for low-income Kansans and the hospitals that serve them. Regardless of how the issue was treated during the election season, Wagnon says her advice to Democrats during the next session is unequivocal.

“I hope they push like crazy to get it passed,” Wagnon says.

Andy Marso is a reporter for KCUR 89.3 and the Kansas News Service based in Topeka.
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