Kansas GOP Can’t Muster Votes to Save Medicaid Expansion (Updated)

Despite 82 percent of Kansans supporting KanCare expansion, enough Republican lawmakers stood with Gov. Sam Brownback to continue to deny health care coverage to about 150,000 people.

Kansas Gov. Sam Brownback ended the push to make health care accessible to people with low incomes. Shutterstock

UPDATE, January 9, 2020, 2:20 p.m.: Kansas Gov. Laura Kelly (D) on Thursday announced an agreement with Republican leadership that would expand Medicaid access for around 150,000 people in the state, the Associated Press reports.

The Republican-controlled Kansas House narrowly failed on Monday to overturn Gov. Sam Brownback’s (R) veto of a bill that would have expanded health care to more than 150,000 Kansans with low incomes.

Although Democrats and some Republicans joined together in support of expanding KanCare, the state’s privatized Medicaid system, the 81-44 vote fell three votes short of the two-thirds majority needed to override the governor’s veto.

Despite 82 percent of Kansans supporting KanCare expansion, enough Republican lawmakers stood with Brownback to deny health care to about 150,000 people who would have qualified under Medicaid expansion. One of the reasons Brownback cited for rejecting expansion is his concern that it “funnels taxpayer dollars to the abortion industry” and “Kansas is a pro-life state, respecting the value and dignity of each unique human life,” as Brownback said in a letter last week explaining his veto.  

“It is clear that 44 members of the Kansas House are wildly out of touch with their constituents, as well as their hospitals, faith leaders, and the majority of advocacy groups in the state,” Laura McQuade, president and CEO of Planned Parenthood Great Plains Votes (PPGPV), said in an emailed statement.

However, an expansion of Medicaid would not result in taxpayer funded abortions since the Hyde Amendment, a federal law, prohibits the use of taxpayer dollars to fund abortion care. The expansion would, though, result in more women gaining access to health coverage. Despite Brownback’s claim that Kansans don’t want their taxes going to organizations such as Planned Parenthood, three-quarters of the national public support continuing federal Medicaid funding to Planned Parenthood for services such as contraception, cancer screenings, and screening and treatment of sexually transmitted diseases, according to a poll by the Kaiser Family Foundation.

“Covering more people with health insurance seems pretty pro-life to me,” said Sheldon Weisgrau, director of the Health Reform Resource Project, based in Topeka, Kansas.

Those who work for low wages are the largest population that would stand to benefit from expansion. Only disabled adults, pregnant people, and parents can qualify for KanCare, and the income requirements for those qualifications are very low. A family of three must have an annual household income of $7,644 or less to qualify, and an adult with no disabilities and no children would not qualify, no matter their income. Expansion would not only raise the income eligibility to about $27,000 annually for a family of three, but would extend eligibility to individuals making up to $16,000 regardless of disability or parental status.

Weisgrau has worked on KanCare expansion for the past six years and in health policy for more than 30 years. He has watched the political climate in Kansas change after years of extreme fiscal policies from the Brownback administration that have wrought economic disaster and resulted in a $342 million budget deficit, outsized cuts to public education and other social services, and credit downgrades.

“Medicaid expansion would have been a boom to the struggling Kansas budget and resulted in more Kansas jobs,” McQuade said. Expansion could create as many as 4,000 new jobs in the next five years, according to a 2013 study by George Washington University

Given the state’s budget woes, there’s a clear economic argument to be made in favor of expansion, Weisgrau said. There is a cost, but what opponents of health-care access often ignore are the increased revenue and savings that expansion would bring. The state pays about 44 percent of the cost of KanCare and the federal government pays the rest. Under Medicaid expansion, the state would pay 10 percent at most, with the federal government covering 90 percent of the cost. Not to mention, Weisgrau said, a healthier population is able to earn more and spend more, generating economic activity.

“This would be budget positive for the state and would bring it at least $70 million in the first year alone,” Weisgrau said. “Thirty-one other states plus D.C. have done this and they are all receiving the savings and revenue I’m talking about. [The governor’s opposition] is a great example in how ideology can cloud facts and pragmatism and reality.”

Advocates of expanding health-care access are looking ahead and considering both what can be done this legislative session, such as amending Medicaid expansion on to other bills.

“It is up to the voters of Kansas to remember the Representatives who voted against the interests of their constituents, and to hold them accountable for their actions,” McQuade said. “PPGPV looks forward to continuing to partner with Kansans, to replace these extreme politicians with moderate, pro-health care lawmakers who want the best for all Kansans.”