Big Kansas Medicaid expansion vote weeks away amid abortion fight. Some see 'delay'

Feb. 10--TOPEKA -- After nearly a decade, Medicaid expansion supporters in Kansas have hoped 2020 will finally mark the year lawmakers extend healthcare to upwards of 130,000 low-income residents. They've been encouraged by a compromise proposal from the state's Democratic governor and a top Republican leader.

But just weeks into the session, supporters are growing furious as the deal becomes tangled in abortion politics.

A key Senate committee was supposed to debate -- and possibly advance -- expansion legislation on Monday or Tuesday. But the group instead gathered for roughly 10 minutes Monday before adjourning.

The committee chairman said it will be at least two weeks before the panel votes, though he contends the delay is unrelated to expansion.

"It's completely unacceptable to hold this bill hostage to abortion politics," Rabbi Moti Rieber, a longtime expansion supporter, said as he left the meeting.

Rieber, who leads Kansas Interfaith Action, slammed what he called a "delay tactic" and described it as "morally abysmal."

"Delay, delay, delay," said Sen. Barbara Bollier, a Mission Hills Democrat running for U.S. Senate.

Senate President Susan Wagle, a Wichita Republican also campaigning for U.S. Senate, on Friday halted action on any bills that could be used for expansion after the House failed to pass an amendment asserting the Kansas Constitution doesn't include a right to an abortion. The Senate won't debate expansion until the amendment passes, she said.

And even if the amendment does pass, "working Kansans should continue to stand with me and fight tirelessly against the expansion of Medicaid for able-bodied adults," Wagle said in a statement.

Her ultimatum comes at a delicate time in the push to broaden eligibility in the healthcare program.

The Senate Public Health and Welfare Committee had already scheduled two days of work this week on the compromise deal crafted by Democratic Gov. Laura Kelly and Senate Majority Leader Jim Denning, an Overland Park Republican. Supporters had hoped the panel would vote this week to send the bill to the floor.

On Monday, the committee's chairman signaled weeks will pass before the group votes, angering supporters and likely cheering critics who want to defeat it. The chairman, Sen. Gene Suellentrop, promised senators an expanded meeting Tuesday even as he outlined a schedule that precludes a vote for at least two weeks.

The Wichita Republican raised concerns on multiple fronts in explaining the decision.

He said expansion would require additional staff in the Kansas Attorney General's Office to investigate Medicaid fraud and indicated those needs came into full view last week when Attorney General Derek Schmidt spoke to the committee. He also raised concerns with how much time and money it will take Kansas to complete a federal waiver request needed for the Kelly-Denning deal to move forward.

Suellentrop told reporters that while he was disappointed in the failed vote on the abortion amendment, the delay in debating Medicaid expansion would have happened regardless.

"These are important issues and they need to be vetted properly before we go forward," Suellentrop said.

In a sharp exchange just before the committee adjourned, Bollier pushed Suellentrop on why the committee wasn't acting more quickly.

Bollier said a majority of senators support the bill, and then asked: "Because you see it differently, that doesn't hold any weight to moving forward?"

"Not at this time," Suellentrop replied.

Republican critics of expansion for weeks have been planning ways to make the proposal more conservative, or even stop it altogether.

The current compromise includes a work referral program, but not work requirements, which are favored by some conservatives but opposed by supporters as a costly administrative burden. "At this point in time, not a single state has a functioning work requirement for Medicaid eligibility," Denning said previously in arguing against work rules.

Some Republicans have also expressed a desire to add provisions allowing doctors to refuse to perform procedures they disagree with on religious grounds, such as abortion. And an ongoing legal challenge to the federal Affordable Care Act, which authorized states to expand Medicaid, is also cropping up in some discussions. The lawsuit, which holds the potential to throw out much of the landmark 2010 law, could ultimately be decided by the U.S. Supreme Court.

"If that thing is found unconstitutional, the unwind of that thing is going to devastate some states," said Sen. Ty Masterson, an Andover Republican who wants to include a trigger that would implement expansion in Kansas only if the Affordable Care Act is found constitutional.

In an interview last week before the abortion vote, Masterson portrayed the committee's work as a sincere effort to fashion a bill and acknowledged "the votes are generally there" to pass expansion. "We're looking at this bill now as if it is going to become law," he said.

But other Republicans still believe expansion can be halted. Conservatives have the most power to change or stop the bill in committee. Once it moves to the Senate floor, supporters have votes to pass it.

"Hopefully, we kill it," Sen. Bud Estes, a Dodge City Republican, said as he walked into the committee meeting.

Lawmakers showed few signs of progress on the abortion amendment Monday. House Speaker Ron Ryckman, an Olathe Republican, said he didn't anticipate his chamber debating the amendment again for a while -- meaning it could be some time before the Senate brings up expansion.

Still, expansion supporters have some levers they can try to pull to force action. Senators could vote to force the bill to the floor, a move requiring 24 votes. The Kelly-Denning bill currently has 22 co-sponsors.

Senate Minority Leader Anthony Hensley, a Topeka Democrat, noted just two more votes would be needed to force the legislation to the floor.

"I think that's probably the only thing that we'll be able to do," Hensley said.

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