Kansas governor proposes paying for Medicaid expansion through legalizing medical marijuana

Feb. 1—Gov. Laura Kelly proposed Monday that Kansas pay for expansion of Medicaid with revenue from the sale and taxation of medical marijuana.

The plan would require lawmakers to legalize the sale of marijuana for medical use, which would likely be controversial. Kelly told reporters that the approach eliminates the argument that Kansas cannot afford to expand Medicaid to provide health coverage for an additional 165,000 low-income residents.

"You have heard many of the comments coming from the opposition have been we can't afford it," Kelly said. "We have just designed a bill that pays for itself and more."

"There's never been any good argument against expansion other than we can't afford it."

Republican lawmakers, however, are already rejecting the suggestion.

"Governor Kelly envisions a Kansas where you can choose not to work and the taxpayers will foot the bill for you to stay home and smoke supposedly medical marijuana," Senate Majority Leader Dan Hawkins said in a statement. "While the Governor is focused on high hopes and pipe dreams, Republicans continue working to create jobs and rebuild the once strong economy."

Kelly expressed support for medical marijuana while campaigning but did not push for it in her first two years in office.

Last month, Kelly included an expansion plan in her annual proposed budget to cover more than 165,000 people starting next year.

She agreed to a bipartisan expansion measure last year, in collaboration with former Senate Majority Leader Jim Denning. But the plan died when former Senate president Susan Wagle made approval contingent on passage of an anti-abortion constitutional amendment. The amendment failed in the House last year before passing in both chambers this year.

With a more conservative legislative body, however, Medicaid expansion is already viewed by many as dead on arrival. Senate Majority Leader Dan Hawkins called the governor's budget proposal, which included a tax on online music and movie purchases and reducing the state's contribution to its pension program, a "trifecta of things that aren't going to go anywhere.

'An island'

Kansas is one of 12 states in the country that has not expanded Medicaid under the provisions of the Affordable Care Act, which calls for the federal government to pay 90 percent of expansion costs.

In August, Missouri voters approved expansion on a ballot initiative.

Chad Austin, president and CEO of the Kansas Hospital Association, said in a University of Kansas Health System briefing he anticipates incentives coming from the Biden administration for "those 12 remaining states that have not moved forward with Medicaid expansion.

Kansas, he said, is "on an island" surrounded by states that have expanded the program.

"From the perspective of the public, I do think that there's still an appetite for Medicaid expansion," Austin said.

"There's been poll after poll that's been done over the last several years that continuously shows that there's public support for Medicaid expansion. So hopefully our policy makers here in Topeka will take advantage of that and find a solution that's right for Kansans."

Currently, KanCare, the state's medicaid provider, is only available to pregnant women, people with disabilities, those over 65 and low income families with children. Families of four must make less than $10,000 to qualify.

200,000 Kansans are uninsured, most because they earn too much to qualify for Medicaid, but not enough to afford insurance on the healthcare marketplace, according to the Kansas Health Institute. Under a proposed expansion, 130,000 of those would qualify for Medicaid beginning in 2022.

April Holman, Executive Director of medicaid expansion advocacy group Alliance for A Healthy Kansas, said many of Kansans not covered have been deemed essential workers during the pandemic — grocery store employees, custodians, food service workers, and more.

"There are so many issues that are really important that Kansas needs to address, and Medicaid expansion as a practical solution that would help with many of them," Holman said. "We need to look at the benefit and the need, and stop getting so twisted up in the political considerations.

Among those uninsured are essential workers like Melissa Dodge, a grocery store worker whose job puts her at high risk of contracting COVID-19 and passing it onto her children.

"I can't quit my job, especially in a time like this, where so many people are losing jobs," Dodge said. "It's a mixed bag of being grateful that I'm employed, and needing that financial stability, but also feeling like I'm putting myself and my family at risk every day that I go to work."

The Kansas City Star's Lisa Gutierrez contributed to this report.

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