Medicaid expansion remains issue in Kansas

Aug. 28--PITTSBURG, Kan. -- Repeated attempts for Medicaid expansion in Kansas have ended in disappointment for supporters, but they say they will not give up.

In 2017, the state Legislature approved expansion, but then-Gov. Sam Brownback, a Republican, vetoed it. Two years later, the Kansas Legislature adjourned without approving a Democrat-led Medicaid expansion plan that would have helped Kansas residents stuck in the so-called medical-insurance coverage gap.

In February, an initial bipartisan effort to expand Medicaid abruptly fizzled when the fates of expansion and a constitutional amendment limiting abortion became intertwined. That occurred when the Kansas House failed to approve the abortion amendment by a two-thirds majority, falling four votes short of the needed 84 votes. Medicaid expansion has remained in legislative limbo ever since.

State lawmakers, however, haven't given up the fight, and on Wednesday, Gov. Laura Kelly reaffirmed her commitment to expanding Medicaid statewide.

"I believe that the most important thing my administration can do is to continue fighting for quality, affordable health care by expanding Medicaid," Kelly said during a brief stop in Pittsburg.

Expanding Medicaid, she said at an event for the Community Health Center, "is about keeping at-risk Kansans in every community safe and healthy now and into the future. It's about improving health outcomes in our community, it's about protecting coverage for preexisting conditions, and it's also about protecting small-town hospitals and boosting their bottom lines to avoid closures" such as Mercy Hospital in Fort Scott last year.

To "add to the urgency," Kelly said, Missouri earlier this month was the latest neighboring state to adopt Medicaid expansion. Colorado had already expanded its Medicaid program, and both Oklahoma and Nebraska had adopted, but not yet implemented, expansion. Kansas is one of only a few states that haven't expanded eligibility for Medicaid, the state-administered program that is largely funded by the federal government.

"Kansas," Kelly said, "is the only state among our neighbors that's failed to expand. While it's been disappointing to see politics put before the health of Kansans, I remain confident we can persuade Legislature leadership to end its obstruction on this issue."

Dr. Lee Norman, secretary of the Kansas Department of Health and Environment, accompanied Kelly on her stop in Pittsburg. While his name has mostly been associated against the fight in the COVID-19 pandemic over the last six months, he said Wednesday that legislators would remain "unrelenting" in their efforts to expand Medicaid.

"One of the things that COVID-19 has done is that it's maybe taken some people's eyes off the ball," he said. However, "it's our absolute commitment to expand Medicaid, immunizations, cancer screenings and mental health."

Medicaid expansion and the other issues, he said, "are some of the big things that we need to not lose trace of."

Many Republican lawmakers aren't sold on Medicaid expansion.

The last thing Kansas needs, said Sen. Richard Hilderbrand, R-Galena, is additional government expansion.

"While the state is looking at a $1.4 billion deficit ... where is the over $100 million in new annual spending going to come from?" he said in a statement to the Globe. "What areas of the budget will be cut, and what taxes will be raised, to pay for the $1.4 billion deficit and the added new spending that expanding Medicaid in Kansas will bring?

"When Kansans are sitting around their kitchen tables figuring out their bills and they don't have enough money to pay them all, they don't look at new ways of spending money," he continued. "They prioritize their current spending and look at what they can do to cut their expenses. The state should be no different. The state of Kansas needs to prioritize their spending and fixing some of the serious problems that it is facing with some of its current programs, before expanding the size of government."

The governor cited a Robert Wood Johnson Foundation county health rankings report that had Crawford County sitting at 91st out of 105 Kansas counties -- "not good," she said.

By expanding Medicaid, it "would have the strongest impact on changing outcomes in communities like Pittsburg," she said. "By giving Kansas access to health insurance, our community partners would no longer have to cover the cost of care of uninsured individuals. This would free up funds to increase urgent care, to add new services, extend community outreach and bolster the local economy."

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