Kansas House Approves Medicaid Expansion

Reps. Susan Concannon and Troy Waymaster debate Medicaid expansion on the House floors.

By John Celock

Following several years of blocked floor votes, the Kansas House of Representatives voted Wednesday to approve the Medicaid expansion in the state.

The House voted 85-40 to approve the expansion, which came up following an effort to block it in the House Health and Human Services Committee. The vote came after several years of Democrats and moderate Republicans attempting to force a floor vote on the issue, which was routinely blocked by former legislative leaders.

“Hospitals do not decide who they are going to take care of according to how they’d pay. They take care of everyone,” Health and Human Services Committee Vice Chairwoman Susan Concannon (R-Beloit) said about the need to do the expansion. “We have got to get a system in place in Kansas that will pay them for what they are doing.”

Concannon said that the state’s smaller hospitals are at risk without the Medicaid expansion funds, pointing to the closing of a hospital in Independence. She noted that the state has lost $1.7 billion in federal funds since the Medicaid expansion was authorized under the Affordable Care Act. Concannon said that a third of the hospitals in the state could close if the Medicaid expansion is not passed.

Medicaid expansion has been a lightening rod subject in Kansas politics for several years with Gov. Sam Brownback (R) and conservative Republican leaders opposing the expansion. Former House Speaker Ray Merrick (R-Stillwater) blocked several attempts to bring Medicaid expansion to the floor in recent years, including removing several pro Medicaid expansion members – including Concannon – from the Health and Human Services Committee in December 2015. House Speaker Ron Ryckman Jr. (R-Olathe) restored Concannon to the health panel last December.

The health committee held three days of hearings on the Medicaid expansion earlier this month, featuring 160 witnesses in favor and five opposed. The committee voted last week to table the bill until April, effectively killing it for this year. House Minority Leader Jim Ward (D-Wichita) made a motion Tuesday to pull the Medicaid bill to the House floor Wednesday. Ward has been known in the past to attempt to bring the Medicaid expansion bill to the House floor.

Ward withdrew his motion Wednesday morning after extracting a promise from GOP leaders to bring a minor mental health bill to the floor Wednesday afternoon that the Medicaid expansion could be amended into.

The vote was on the amendment to the mental health bill. The final vote on the expansion was 83-40.

Supporters of the Medicaid expansion said that the bill would increase health care access and bring money into the state. Supporters also said increased health care access would increase economic development in the state through a healthier workforce. Opponents said that there is no guarantee that the federal funding would continue, noting that President Donald Trump and the GOP-controlled Congress have said they want to repeal and replace the Affordable Care Act, which contains the Medicaid expansion.

Rep. John Whitmer (R-Wichita) said that the states that have enacted Medicaid expansion have seen cost overruns in their first years. He cited figures including Alaska being $61 million over budget, California being $14.7 billion over budget and Illinois being $2 billion over budget.

“Unless you want to vote for another tax increase that is relevant information you ought to consider,” Whitmer said.

Concannon said that the figures cited by Whitmer were the result of backlogs in enrollment. She said that she has received regular briefings on the issue as the health committee co-chairwoman of the Council of State Governments West and that states nationally have been clearing up backlogs.

Health and Human Services Committee Chairman Dan Hawkins (R-Wichita) questioned the long term viability of doing the Medicaid expansion, noting that there is no guarantee that the federal government would continue funding 90 percent of the state’s cost.

“How do you deal with that?” Hawkins said. “Don’t start something you can’t keep going.”

House Appropriations Committee Chairman Troy Waymaster (R-Russell) echoed comments similar to Hawkins, noting that the state has a budget shortfall that his committee is still working on. He also noted that the state has not enacted a tax plan.

Concannon noted that the bill contained a provision that would stop the program if the federal government dropped its contribution. This provision has been common in multiple Republican states that have enacted the Medicaid expansion.

Concannon also questioned if Trump would eliminate the Medicaid expansion funds.

“There is an unknown out there about what will happen. I believe that the President said that it would be repealed and that did not happen. When you are in the position you find out more about it,” she said. “You find out that it is not as easy to repeal as one thought. There have been some articles that quoted the president of saying that it would be up to a year. With that said there are 31 states that have expanded and about half are GOP states and they have asked for the expansion to continue.”

Rep. Cindy Neighbor (D-Shawnee) said that the bill was not a partisan measure.

“This is about a life. This is not about being a Republican, this not about being a Democrat, this is not about being a Libertarian,” she said. “This is about life.”