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Health

Kansas Lawmakers: Purge Will Only Add Momentum To Medicaid Expansion Debate

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Kansas Legislature
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Two Kansas lawmakers who lost their health committee assignments because they support Medicaid expansion say the purge has given the issue more momentum.

Interviewed over the weekend for KCUR’s “Statehouse Blend” podcast, Republican House members Susan Concannon, from Beloit, and Don Hill, from Emporia, said Speaker Ray Merrick’s decision to remove them from the Health and Human Services Committee was a mistake if his goal was to shut down discussion on the expansion issue.

“I think the leadership was shortsighted and ill-advised,” Hill said. “The response I’ve had from my constituents has been overwhelming. There is a sentiment that they’ve been deprived a voice.”

News of the purge broke just as Concannon, the vice chairwoman of the committee, was sending her annual pre-session survey to constituents.

“A day or two after the news hit, people were filling out the survey,” she said. “So, I am getting a lot of feedback right now and people are quite upset.”

Merrick, a conservative Republican from Stilwell, issued a statement confirming he ordered the shake-up because of his opposition to the Affordable Care Act and Medicaid expansion.

“Kansans oppose expanding Obamacare, a program that has busted budget after budget in states that have expanded it,” Merrick said. “I will continue to fight to protect Kansans from the disastrous effects of Obamacare.”

Merrick and other GOP leaders, including Gov. Sam Brownback, oppose expansion in part because they say it will provide coverage to non-disabled adults while Kansans with disabilities continue to wait for Medicaid support services that allow them to live independently.

In a blog posted recently to the website of the House Republican caucus, Rep. Dan Hawkins, the chairman of the HHS committee, said the state has a "responsibility to provide a healthcare safety net to the poor, disabled and elderly." But he added, "My concern begins when we expand that to able-bodied adults with other health care options."

The expansion issue has gained little traction in the Legislature despite a strong lobbying effort by Kansas hospitals. However, two recent events — the closure of a southeast Kansas hospital and a Wichita forum where Kansas lawmakers discussed a conservative expansion plan implemented by Republican Gov. Mike Pence in Indiana — were starting to generate more serious discussion of the issue, Concannon said.

The health committee purge, she said, was an attempt to blunt whatever progress expansion advocates were making and to warn House Republicans to stop “discussing these hare-brained ideas.”

Characterizing Merrick’s actions as “heavy handed,” Hill predicted they wouldn’t work. The financial struggles of other rural hospitals, growing support from religious and business groups, and polls that show that a majority of Kansans support expansion will at some point force lawmakers to deal with the issue, he said.

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Rep. Don Hill, of Emporia, is a pharmacist. He calls the decision to remove three moderate Republicans from the Health and Human Services Committee 'shortsighted and ill-advised.'

“The grassroots effort is building, there’s no doubt. And I think the developments of the 11th of November have only increased that momentum,” Hill said, referring to the date on which he and Concannon were removed from the committee, along with Rep. Barbara Bollier, a Mission Hills Republican, and Kevin Jones, a Wellsville Republican.

Concannon agreed that support for expansion was building. But she said because of the state’s ongoing budget problems and election year politics, it won’t be approved in the 2016 session.

“I really don’t think it’s got a prayer for this session,” Concannon said. “It will happen. It’s just a matter of when it’s going to happen.”

Brownback privatized the Kansas Medicaid program in 2013. Now called KanCare, the nearly $3 billion program is administered by three managed care organizations.

Expansion would extend KanCare coverage to non-disabled, childless adults with incomes up to 138 percent of poverty, $16,105 annually for an individual and $32,913 for a family of four. 

It is estimated that expansion initially would provide coverage to approximately 150,000 Kansas, many of whom are now uninsured because they make too much to be eligible for the state’s existing KanCare program but too little to qualify for federal tax subsidies to help them purchase private coverage in the ACA marketplace.  

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

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