Our last report covered the meeting of the Senate Select Committee on Health Care Access chaired by Senator Gene Suellentrop (R-Wichita) who has opposed Medicaid expansion during his tenure in the Senate. At that meeting, we witnessed the unveiling of a Medicaid expansion plan written by Senator Jim Denning (R-Overland Park) who has worked with Senate President Susan Wagle to obstruct discussion of Medicaid expansion throughout his time in the Senate.
Denning’s plan is quite complex and would require multiple waivers of federal law under both the Americans with Disabilities Act and the Medicaid Act.
We just attended another meeting of Governor Laura Kelly’s Council on Medicaid Expansion which has been tasked with bringing forth four or five key goals and concepts around which the expansion of Medicaid should take place. The Governor’s Council, during its first meeting, brought in experts from around the country who have been dealing with Medicaid expansion from the beginning including Hemi Tewarson, Director of Health in the National Governors Association Center for Best Practices and Cindy Mann, a partner at Manatt Health, who, at one time, worked at reviewing Medicaid plans and waivers for the federal government.
The Governor’s Council also heard at this meeting from Kathleen Stiffler, Director of the Bureau of Medicaid Care Management and Customer Service in the Michigan Department of Health and Human Services. Michigan adopted Medicaid expansion in 2014. This brings to three the number of states that have appeared before the Council. At their last meeting, they heard from Ohio and Montana – states that passed expansion under a Republican and Democratic administration, respectively. Michigan achieved expansion under a Republican governor and legislature. All three states praised the results of expansion both in terms of health outcomes for their citizens and in economic returns for the state.
One key to Denning’s bill is a provision that would require two waivers under which Kansans earning between 100% and 138% of the federal poverty level (FPL) could choose whether to participate in Medicaid or instead enter the ACA and use federal tax credits to offset the cost of private insurance through the ACA exchange. Presentations this week revealed the same waivers have been sought by other states and in all cases, the waivers were either denied or simply not considered by the federal government. Medicaid expansion under the law is allowed for those earning 138% or less of FPL.
The Alliance for a Healthy Kansas, of which KNEA is a member, also weighed in on recent events saying the following:
We appreciate the Senate’s engagement in the expansion conversation. Closing the coverage gap for Kansans would bring hundreds of millions of federal tax dollars back home, insure tens of thousands of Kansans, create thousands of jobs and stimulate our economy.
However, this new bill has many components that need careful review. We are committed to working with our Coalition of 100+ organizations to study this proposal and ensure it improves the health of our citizens and ultimately our state. Already, we know that certain provisions–such as the high premiums and the complex waiver requests–will require serious discussion.
We will be watching all of the proceedings around this important issue in the lead up to the 2020 legislative session.