The KCUR news staff presents the State of Kansas City series as a look ahead to 2020 on topics of importance to the region. Find the State of Kansas City report on other topics in the series as they are published each weekday, Jan. 6–Jan. 20. Follow coverage on these topics at KCUR.org and on 89.3 FM throughout the year.
Health care — who gets it, who doesn’t, and how we pay for it — will command as much attention in Missouri and Kansas politics this year as on the national scene.
While Washington wrestles over fixes for bloated drug prices and surprise medical bills, politicians closer to home will continue years-long battles over other hot-button topics. Kansas and Missouri remain among the shrinking minority of states that never expanded Medicaid. Pressure is mounting that could force political compromise in Topeka soon.
Meanwhile, Missouri is down to one abortion clinic, fighting state efforts to strip its license. In Kansas, abortion foes are gearing up to ask Kansans to change their state’s constitution after the Kansas Supreme Court ruled last year that women have the right to terminate a pregnancy.
WHY YOU SHOULD CARE
Hundreds of thousands more people would qualify for Medicaid in Missouri and Kansas under expansion, though critics and advocates continue to fight over its budgetary implications. Hospitals desperate for the added coverage say it would shore up their finances in rural and low-income areas where they serve more uninsured people.
Meanwhile, efforts to stop abortions in Kansas and Missouri could sway upcoming elections, pushing more people to the polls in Kansas, especially if a constitutional amendment makes it onto the 2020 ballot.
WHAT TO WATCH FOR
- Missouri legalized medical marijuana last year, but cannabis isn’t expected to be available at dispensaries until later this year. The state is working on licensing. Would-be entrepreneurs with local roots worry companies from other states will squeeze them out in that process.
- With ever more teens vaping, schools and cities are taking Juul, the nation’s biggest producer and marketer of vaping devices, to court as they try to beat back its toll on classroom learning and public health.
- Scores of cities and counties have also joined a massive federal lawsuit against the opioid industry, which eventually could lead to settlement payouts for communities across both states.
- The turf war between nurse practitioners and doctors will continue. Both Kansas and Missouri give doctors market power over NPs that many states no longer allow. Expect another legislative showdown this spring, particularly in Topeka.
- As rural hospitals continue to struggle, the threat to communities where they offer care and are often among the biggest employers will up the pressure on lawmakers to consider Medicaid expansion.
BY THE NUMBERS
5: The combined number of abortion clinics left in Missouri and Kansas
802,100: People in Missouri and Kansas who had no health insurance as of 2018
11: Rural hospitals that have closed in Missouri and Kansas since 2005
4: States left without any legal access to cannabis, including Kansas
Missouri Gov. Mike Parson
Last year, Missouri Gov. Mike Parson created a task force to explore reforming MO HealthNet, the state’s Medicaid program. Parson has said that could include looking into Medicaid expansion, a move that Missouri Republicans have strongly resisted.
Some critics worry that the task force may recommend asking the federal government for a waiver to add work requirements or other criteria to MO HealthNet, which would limit eligibility and leave some vulnerable Missourians without access to health care.
Medical marijuana entrepreneurs
Many Missouri entrepreneurs have worked closely with local patients’ groups and medical marijuana supporters. Now that medical marijuana is legal, these would-be business owners fear out-of-state companies will dominate Missouri’s medical marijuana industry.
Kansas Gov. Laura Kelly and Kansas Sen. Jim Denning of Overland Park
The Kansas Senate majority leader has long opposed Medicaid expansion, but pressure from more moderate Republicans and from Gov. Laura Kelly and other Democrats may force compromise in the Legislature this year.
Denning, an Overland Park Republican, is playing a key role in those talks, and recently said a deal is imminent. That comes after the Kansas House voted for expansion last year but Denning and other key senators blocked a vote in Senate. Two years earlier, both chambers approved expansion, but then-Gov. Sam Brownback vetoed it.
Anti-abortion advocates like Kansans For Life secured a slew of restrictions against the procedure during the Brownback years. But they could have a much bigger impact on state abortion policies this year if lawmakers agree to put a constitutional amendment to a public vote, with the goal of undermining last year’s Kansas Supreme Court ruling that found a right to abortion in the Kansas Constitution.
Jan. 13: The Kansas Legislature gets back to work, with a Medicaid expansion compromise tops on the to-do list.
Jan. 31: Deadline for Missouri’s Medicaid task force to issue its recommendations.
Nov. 3: General election. Some health questions that might go to a public vote include Medicaid expansion in Missouri (if a statewide petitioning effort is successful), and an anti-abortion amendment to the Kansas Constitution.
Celia Llopis-Jepsen reports on consumer health and education for the Kansas News Service. You can follow her on Twitter @Celia_LJ.
Dan Margolies is a senior reporter and editor at KCUR. You can reach him on Twitter @DanMargolies.
Alex Smith is a health reporter for KCUR. You can reach him by email at email@example.com.