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Kansas Medicaid Expansion Proponents Prepare To Make Their Case

Andy Marso
Heartland Health Monitor

Supporters of expanding Medicaid in Kansas are finally getting an opportunity to make their case to lawmakers.

Republican legislative leaders opposed to expansion have blocked hearings on the issue for two years. They agreed to allow hearings this year only after supporters in the Kansas House threatened to force an immediate vote on the floor.

Those hearings are scheduled for Wednesday and Thursday in the House Health and Human Services Committee on House Bill 2319, which requires the Kansas Department of Health and Environment to develop an expansion plan and negotiate its approval with federal officials.

A dozen carefully selected supporters of expansion are scheduled to testify on the first day.  They represent hospitals, doctors, safety net clinics and some large businesses.

Dozens of others are expected to submit written testimony. The committee staff has been told to expect 150 pieces of written testimony in support of expansion.

Approximately four opponents are expected to testify on Thursday.

Rep. Dan Hawkins, the Wichita Republican who chairs the committee, is opposed to expansion but said he wants the hearings to be even-handed.

“We’ve worked overtime just to make sure that everything is fair for both sides,” Hawkins said.

Hawkins said he expected proponents to testify about why expansion is needed to provide coverage for uninsured adults and to offset Medicare reimbursement cuts to hospitals.

“They’re going to tell us what that need is,” Hawkins said. “I don’t expect to hear a lot about numbers, I think it’s going to be more of an emotional plea about why it’s needed.”

By that, Hawkins means he doesn’t expect to hear a lot about how much expansion may cost the state. That testimony, he said, will be provided by the Kansas Department of Health and Environment on Thursday.

Supporters will likely focus on different numbers. They will talk about how many uninsured adults will gain coverage and trumpet studies funded by the hospital association and others that show how billions of additional federal Medicaid dollars would boost the Kansas economy.

A study commissioned by the hospital association estimated expansion would cost the state an additional $312 million through 2020 but said an infusion of $2.2 billion from the federal government between 2016 and 2020, combined with potential savings in other programs, would more than offset that cost.

After the hearings, the committee won’t have time to “work” the expansion bill and vote on whether to send it to the House floor, Hawkins said.

“I’m just not sure how it goes from here because our committee time is up,” he said.

Rep. Jim Ward, from Wichita, is the ranking Democrat on the health committee. He acknowledged that a committee vote is unlikely, but said he and other supporters continue to look for ways to force a vote in the full House.

“We’re not done yet,” Ward said. “I’m pretty sure we’re going to have a vote on the House floor one way or the other. The tool box still has some tools in it.”

Ward and other supporters were encouraged recently when Gov. Sam Brownback appeared to soften his opposition to expansion in remarks to a group of conservative lawmakers in Missouri.

Despite insistence from some expansion opponents that the governor hasn’t changed his position, Ward said he believes the governor and others are open to compromising on a proposal that takes a more conservative approach to expansion.

“I’m going to take the governor at his word when he spoke in public and said that he would sign a Medicaid bill if it’s paid for,” Ward said. “I’m going to do everything in my power to give him that opportunity.”

Kansas’ privatized Medicaid program, KanCare, covers about 425,000 children and low-income, disabled and elderly adults. But that number includes relatively few non-disabled adults. Adults with dependent children can participate in KanCare, but only if they have incomes below 33 percent of the federal poverty level, or a little more than $8,000 annually for a family of four. Adults without children aren’t eligible for coverage no matter how poor they are.

Adults without children aren’t eligible for coverage no matter how poor they are. Expansion would make all Kansans with incomes up to 138 percent of poverty eligible for KanCare. The eligibility cap would be set at annual income of $16,105 for an individual and $32,913 for a family of four.

Estimates vary, but Medicaid expansion would extend coverage to between 140,000 and 170,000 Kansans.

Correction: The story has been revised to state that adults with dependent children are eligible for KanCare if their incomes are below 33 percent of the federal poverty level. 

Jim McLean is executive editor of KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

Jim McLean is a political correspondent for the Kansas News Service, a collaboration based at KCUR with other public media stations across Kansas. You can email him at jim@kcur.org.
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