The odds that the Kansas Legislature will pass a Medicaid expansion bill this session remain long.
But they improved Thursday, however slightly, when conservative Republican leaders agreed to allow a hearing on expansion to avoid an immediate vote on the House floor.
Rep. Jim Ward, a Wichita Democrat, was attempting to amend his Medicaid expansion proposal into an unrelated bill. Uncertain how a vote might turn out, House leaders dropped their opposition to a hearing in exchange for Ward withdrawing his amendment.
Rep. John Wilson, a Lawrence Democrat, said the tactical maneuver “disrupted the plan” that GOP leaders had to block any consideration of Medicaid expansion.
“We now have a new opportunity in front of us to talk about expansion and to talk about the Kansas Hospital Association’s plan,” Wilson said.
The hospital association has been working behind the scenes with Gov. Sam Brownback and legislators to craft an expansion plan similar to those being proposed by other Republican governors. These so-called red state expansion plans use federal Medicaid funds to help low-income adults purchase private coverage. They also require recipients to share in their health care costs in ways that traditional Medicaid doesn’t.
A bill drafted by the House Vision 2020 Committee contains elements of a possible Kansas plan. It includes a mechanism for covering the state’s share of expansion costs, something that may prove essential given the state’s budget problems.
Just last week, Rep. Dan Hawkins, a Wichita Republican and chairman of the House Health and Human Services Committee, said he had no plans to schedule hearings on expansion.
Ward’s agreement with GOP leaders changes that. At some point during the second half of the session the House will have a hearing on the expansion bill introduced at the request of the hospital association, which seeks to repeal a 2013 proviso that prohibits Gov. Sam Brownback from crafting an expansion plan and negotiating its approval with federal officials.
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, $7,770 annually for a family of four. 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 an annual income of $16,105 for an individual and $32,913 for a family of four.
Rep. Don Hill, an Emporia Republican who has been working with the hospital association, said if a Medicaid expansion bill reaches the House floor, it might pass.
“It very well might be a close vote,” Hill said. “But I think there is a lot of bipartisan support for Medicaid expansion in the Legislature and in the House in particular.”
Jim McLean is executive editor of KHI News Service in Topeka, a partner in the Heartland Health Monitor team.