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Backers Of Kansas Medicaid Expansion Pack Hearing, But Can They Change Policy?

Jim McLean
/
Kansas News Service
Supporters of Medicaid expansion packed a Kansas Senate hearing room on Wednesday.

When it comes to packing Statehouse hearings, few groups fill a room more reliably than those pushing for Medicaid expansion.

What they’re less good at, at least so far, is convincing lawmakers and a governor to expand Medicaid eligibility to another 150,000 low-income Kansans.

They came close last year: Lawmakers passed an expansion bill, but came a few votes short of overriding then-Gov. Sam Brownback’s veto.

Again this year, they face opposition from conservatives — notably Gov. Jeff Colyer — who still object to the Obama-era Affordable Care Act. Those forces worry about bloated government services and asking taxpayers to foot health care costs for a larger group of people.

Expansion supporters launched their 2018 effort Wednesday, flooding the Senate Public Health and Welfare Committee with testimony from 140 individuals and organizations.

It came from doctors, hospital administrators, business leaders and every-day Kansans like Amy Houston, who thought it appropriate the hearing was on Valentine’s Day.

“I have the compassion, hope and love that I’m going to give you this message and you’re going to accept it and not turn me away,” Houston said.

A small business owner from Mulvane, Houston talked about struggling to maintain health insurance during her nine-year battle with cancer.

Randy Peterson, CEO of Stormont Vail Health in Topeka, warned of hospital closings without the additional federal money that expansion would bring.

“These dollars could be the very margin for these hospitals to remain open,” Peterson said.

Sheldon Weisgrau, the director of a pro-expansion coalition funded by several Kansas health philanthropies, touted studies that document the economic benefits of expansion.

Credit Jim McLean / Kansas News Service
/
Kansas News Service
Sheldon Weisgrau, who heads a coalition pushing Kansas lawmakers to expand Medicaid to cover more people, speaks at a Senate committee hearing Wednesday.

“In Colorado, the gross domestic product has increased by more than 1 percent as a result of expansion,” Weisgrau said. “That doesn’t sound like a lot, but an equivalent increase in Kansas could be $2 billion of additional economic growth.”

Though outnumbered, expansion opponents — most representing conservative groups with ties to the Koch brothers — pushed back. They argued that expansion was little more than an expensive new entitlement for people who may not deserve taxpayer-funded health coverage.

“These adults don’t have disabilities,” said Gregg Phister, government affairs director for the Florida-based Foundation for Government Accountability. “Most of them are without children and don’t work a full-time, year-round job.”

Phister said expansion has “been a disaster” in many of the 32 states that have adopted it due to enrollment that has swamped projections and driven up costs.

Asked by Sen. Ed Berger, a Hutchinson Republican, whether any expansion state had reversed course, Phister said none had but some were discussing it.

Jeff Andersen, acting secretary of the Kansas Department of Health and Environment, the state’s lead Medicaid agency, detailed the Colyer administration’s opposition to expansion.

Among other things, Andersen said continued efforts by the Trump administration and Republican leaders in Congress to repeal Obamacare should give Kansas lawmakers pause. Most immediately concerning, he said, are questions about whether the federal government will continue to pay 90 percent of expansion costs.

“Yet this month, our governor has meetings scheduled with leaders in Washington … to get a better handle and guidance on where the feds are going,” Andersen said.

Weisgrau said GOP efforts to repeal Obamacare will continue to be thwarted by Republican governors in expansion states “lobbying to keep it.”

“Don’t listen to those people who continually say ‘no’ and offer no alternatives,” he told members of the committee, who are expected to vote on the bill Monday.

Currently, KanCare eligibility is limited to children, pregnant women, people with disabilities and seniors in need of long-term care who have exhausted their financial resources. Parents are eligible only if they earn less than a third of the federal poverty level, less than $10,000 for a four-person family.

Single adults without children currently are not eligible no matter their income. Expansion would extend eligibility to all Kansans who earn up to 138 percent of the poverty level, or about $17,000 annually for an individual and approximately $34,000 for a family of four.

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Jim McLean is managing director of the Kansas News Service, a collaboration of KMUW, Kansas Public Radio and KCUR covering health, education and politics in Kansas. Follow him on Twitter @jmcleanks.