Session ends; Sine Die set for May 29

May 7, 2019 by

Session ends; Sine Die set for May 29

Moderate Republicans abandon efforts on Medicaid/KanCare expansion

KanCare expansion – an effort to provide health care to 150,000 uninsured working Kansans – failed late on May 4 as moderate Republican members of the Kansas House of Representatives abandoned a bipartisan effort to force a vote on the issue in the Senate.

A coalition of Democrats, moderate Republicans, and even some conservative rural Kansas representatives vowed to hold the budget hostage until Senate President Susan Wagle and Majority Leader Jim Denning allowed the full Senate to vote on HB 2066, the bill that would expand KanCare.

While more than 70% of Kansans and majorities in both the House and Senate support expansion, four recalcitrant legislators – Wagle, Denning, House Speaker Ron Ryckman, and House Majority Leader Dan Hawkins – oppose it and have used their power to control what bills will be allowed to be debated to stymie the will of the Legislature and the electorate.

When the House dug in on the issue, voting repeatedly to not adopt the budget but send it back to conference, Wagle, Denning, Ryckman and Hawkins tried to punish them by cutting vital parts of the budget. Their tactic didn’t work. But neither would Wagle nor Denning allow a vote.

Eventually Denning promised that the Senate would take the issue up in January of next year. With this “promise,” moderate House Republicans abandoned the effort and voted to approve the budget leaving only the Democrats along with moderate Republican Diana Dierks and conservative Republicans Jesse Burris, Randy Garber, Michael Houser, and Trevor Jacobs voting NO. Garber and Jacobs represent communities (Horton and Fort Scott respectively) in which hospitals have been forced to close in part due to the state’s failure to expand KanCare.

Sadly, the working poor now have their fate in the hands of a man, Jim Denning, who has suggested to the press that insurance isn’t that helpful (he says his wife almost died and she has insurance) and that the poor can just go to the emergency room if they have a problem. And Denning has used his position as Majority Leader to fight against expansion at every turn. Yet, we are supposed to trust that he will make sure it comes up for a vote in January.

While HB 2066 – the expansion bill – has passed the House and so continues to be “alive” for the 2020 session, we can expect Denning and the other anti-expansion leaders in the Senate to seek the addition of “poison pills” to the bill in their attempt to kill it. And of course the addition of just one amendment to the bill would make it subject to a conference committee which would be made up of four anti-expansion Republicans and two pro-expansion Democrats.

Given Denning’s “promise,” this would be our expectation – that the Senate put HB 2066 on the floor for a vote in January and that the bill will be on the Governor’s desk for her signature by February 1. This is only possible if Denning keeps his word and if moderate Republicans stand up firmly and demand that Wagle, Denning, Ryckman, and Hawkins stop their obstructionism.

Multi-National Corporations are the big winners

Picking winners and losers in the actions of this Legislature is easy.

The working poor lost – they will go at least another year without health care.

Multi-national corporations and the highest earning individuals are the winners. At the end of the session, the House and Senate adopted HB 2033, a somewhat watered down version of the massive corporate tax cut vetoed earlier in the session by Governor Laura Kelly. The bill will cost the state about $245 million over three years.

Some in the Legislature are trying to focus on a provision in the bill dealing with sales tax on groceries. Don’t be fooled – while this bill could reduce the sales tax on food, it is not guaranteed because a reduction in the food sales tax is tied to increases in collections of the compensating use tax. It those collections go up, the food sales tax might come down. If all the assumptions made in crafting the bill turn out to be correct, the food sales tax could drop from 6.5% today to 6.0% in 2021 and then to 5.4% in 2022.

So the bill contains guarantees for multi-national corporations and wishes for the rest of us. But it passed 83 to 41 in the House with one Republican (Pannbacker) voting NO and one Democrat (Pittman) voting YES and 27 to 13 in the Senate with two Republicans (Pilcher-Cook and Skubal) joining all the Democrats in voting NO.

We have yet to see if Governor Kelly vetoes this bill or not.

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House digs in on Medicaid expansion demanding a Senate vote!

May 4, 2019 by

With Senate President Susan Wagle (R-Wichita) and Majority Leader Jim Denning (R-Overland Park) steadfastly refusing the allow a vote on KanCare (Medicaid) expansion in the Senate even though it is supported by a majority of Senators, House Democrats and Moderate Republicans have decided to take a stand.

Yesterday they united behind a motion by Don Hineman (R-Dighton) to send the budget back to conference clearly with the intent of holding passage of the budget until the Senate takes a vote on expansion. A coalition of Democrats, moderate Republicans, and some more conservative Republicans from rural areas voted 63 to 61 to send the budget back to conference.

Watching from the gallery one soon saw Wagle and Denning cross the House floor and disappear back into the offices of House leadership. Speaker Ron Ryckman (R-Olathe) and Majority Leader Dan Hawkins (R-Wichita) are also opponents of expansion.

The decision from leadership was then to punish the House by slashing spending in the budget by about $30 million, reducing funding for Regents institutions, a program for improving health care access, a task force charged with helping keep children and families together, and Larned State Hospital. We imagine the idea was to show the members of the House that if they stuck to their position, leadership would force them to accept a worse budget bill.

Well, if that was the idea – that you could scare the House into backing down and accepting the obstructionism of Wagle and Denning – they badly misread the chamber. This time the budget was rejected on a vote of 42 to 81.

The challenge for Wagle, Denning, Ryckman, and Hawkins who are working hard to block majorities in both chambers from passing KanCare expansion is that the Legislature must pass a budget. They cannot adjourn without a budget.

After the second defeat, budget negotiators went back late last night and restored the cuts they had made in the second conference committee report. Now there is a budget that the majority will support if the Senate will agree to vote on KanCare expansion. Both chambers adjourned for the night after 10:00 and will return this morning, the House at 10:00 and the Senate at 11:00.

KanCare expansion will provide health care to as many as 150,000 uninsured Kansans at a cost of about $57 million to the state, much of which is offset by a small premium cost that was added when the bill passed the House. The federal government will pay 90% of the cost of expansion. Since the program was created under the Affordable Care Act, Kansas has turned away over $3 billion in federal money that would have provided health care for the working poor. Thirty-six states, including some solidly Republican states, have already adopted expansion. Polls show over 70% of Kansans support expansion and a majority of Kansas legislators in both chambers support expansion. It is the recalcitrance of Wagle, Denning, Ryckman, and Hawkins that is stopping Kansas from adopting expansion.

Why is expansion important:

  • Economic growth – KanCare expansion will help stimulate the economy and create thousands of jobs. A study by George Washington University found that expanding KanCare would create 3,500–4,000 new jobs in the next five years.
  • It is a Kansas-based solution – Each state that expands its program can tailor it to the state’s particular needs. Among the features Kansas could draw on are requirements that beneficiaries share the costs of premiums and out-of-pocket expenses, incentives for healthy behaviors, and referral to job training for those who might need it.
  • It protects access to care, especially in rural areas – When Mercy Hospital in Independence closed in October 2015, thousands of people lost nearby access to emergency care, surgery, and other health care services; 190 people lost jobs. Effects of the closure are felt throughout the community.
  • It helps 150,000 hardworking Kansans who cannot afford coverage– These are our family members, friends, and fellow Kansans who don’t make enough money to afford quality health insurance but have incomes that are too high to qualify for KanCare. Most are employed and many work multiple jobs to provide for their families. These are Kansans stuck in the coverage gap, with no affordable insurance options.
  • It helps thousands of uninsured military veterans and their families– About 7,400 veterans and their spouses would gain access to quality, affordable health care coverage with KanCare expansion. Veterans often do not have automatic and easy access to health care through the Department of Veterans Affairs, despite their service to our country.
  • It controls health insurance costs – Without KanCare expansion, the state’s uninsured will continue to forego necessary health care or seek it in the most expensive place — the emergency room. So long as thousands of working Kansans remain uninsured, the health care they inevitably need but cannot afford ends up raising the costs of health care for others in the state — employers, hospitals, local governments, and privately insured individuals and families.

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Legislative wrap-up session starts on Wednesday

Apr 29, 2019 by

The part of the 2019 legislative session that begins on Wednesday was once called the “veto session.” This three-day event allowed legislators to deal with possible overrides on bills the Governor might have vetoed between the end of the regular session and this one. But recently, it has become a time when major pieces of legislation finally get passed.

Most notably, school finance and the state budget have been held until this time and that’s why the supposed three-day session often winds up being much longer.

In an unusual twist this year, the school finance bill has already be adopted and signed into law by the Governor! So that means at least one part of the heavy lifting has been done. Will this mean the three-day session will end on Friday? That depends on what’s left.

The Budget

Before the end of the regular session, budget negotiators hit an impasse and decided to wait until this week to finish things up. There wasn’t a lot of disagreement so one might be inclined to think things could go quickly. They have the April revenue estimates so they know what they have to spend so here’s hoping that might be wrapped up in short order.

A new abortion debate

There’s also the outrage among Republican leaders on last week’s Kansas Supreme Court ruling that the state constitution allows for abortion. Whether or not a constitutional amendment will be taken up is a big question out there right now and, as we have seen, abortion legislation can take up a lot of hours in the Statehouse. Some have raised the idea of an outright ban on abortion as a constitutional amendment while others want to amend the constitution to say a woman does not have a constitutional right to an abortion, thereby allowing the legislature to pass more bills restricting that right. This could get ugly and contentious really fast.

KanCare/Medicaid expansion

Finally, there is KanCare expansion. KanCare is the state’s Medicaid program. More than 150,000 Kansans fall into a health coverage gap. They earn too much to qualify for KanCare but not enough to be eligible to get financial help to buy private insurance. Rep. Don Hineman (R-Dighton) explains the issue best:


“Many expansion beneficiaries are the working poor who don’t receive health insurance at work.  They serve in food service, make beds at hotels, and scramble to make ends meet with two or three part-time jobs.  They are young entrepreneurs who have taken a chance on a business which has not yet achieved profitability.  Or it’s someone who wants to take that step but cannot accept the risk, so they stay in a job that isn’t ideal merely to get health insurance.  Individual entrepreneurship is a cornerstone of our free-market system.  But crushing insurance costs are stifling the dreams of too many would-be Kansas entrepreneurs.  Expanding Medicaid creates opportunities for them and for the Kansas economy.”

KNEA supports KanCare expansion. It is good for our health care system – we’ve already lost five rural hospitals due in part to uncompensated care and 86% of Kansas hospitals have negative operating margins. Some of those who would be helped serve our schools such as part-time support service providers like cafeteria workers, bus drivers, and para-professionals. And 90% of the cost of expansion will be paid by the federal government. Tax dollars paid by Kansans would be returned to Kansas in a program that helps the working poor and supports our hospitals.

The Kansas House has already passed expansion this year. In the Senate, there will be a motion to bring the House bill out of committee and onto the Senate floor. That motion requires 24 votes. A subsequent motion to bring the bill up for debate will require 27 votes. The Senate and House both passed expansion in 2017 only to have then-Governor Sam Brownback veto it. This time, Governor Laura Kelly will sign it.

We urge all Kansans to contact their Senator and ask him or her to support three motions: 1) the motion to bring HB 2066 out of committee and to the Senate floor, 2) the motion to bring HB 2066 up for debate and action, and 3) a motion to advance the bill to final action. Then they need to support the bill on a final action vote. Ask them also to oppose all amendments to the bill. Amending it will just throw it to a conference committee and allow time to run out without action.

CLICK Here to write a personal message to your Senator.

CLICK Here to use an email alert from the Alliance for a Healthy Kansas.

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KanCare Expansion in the Senate

Apr 15, 2019 by

On May 1, when the Legislature returns for their wrap-up session, the Senate will consider a motion by Senator Anthony Hensley (D-Topeka) to bring HB 2066 out of committee and on to the Senate floor for debate and action.

HB 2066 came to the House floor in a different form than what the Senate will consider but on a motion by Rep. Kathy Wolfe Moore (D-Kansas City), the bill was amended to be a Medicaid expansion bill (Medicaid in Kansas is called “KanCare”). The amendment was adopted on a vote of 69 to 53 but only after House leadership tried to stop it by ruling the amendment not germane to the topic in the bill. The House voted to overrule leadership – a very rare action which indicated a strong desire by the majority to act on KanCare/Medicaid expansion.

HB 2066 passed the House on March 21 on a vote of 69 to 54. But since then, leadership in the Senate has done everything in their power to make sure the bill does not get a vote in the Senate.

Polls consistently show that between 70 and 80% of Kansans want the state to adopt expansion. Why? Well, there are several good reasons.

  • All Kansans pay federal income tax and some of that tax money is sent back to states to pay 90% of the cost of Medicaid expansion. The states that don’t expand are leaving those dollars in Washington. Kansas has already forfeited over $3 billion that could be brought back to Kansas in the form of health care for working Kansans.
  • Rural hospitals in Kansas are closing. Five have already closed while others are on the brink of closing. Medicaid expansion would bring health care dollars back into Kansas communities and in-turn support the fiscal health of rural hospitals and the communities they serve.
  • If you have health insurance, your premiums are impacted by those who don’t. People who lack health insurance rely on expensive emergency rooms for care. Covering the cost of that care is part of the reason hospital bills are so high – the cost of the uninsured is passed on to the insured through higher medical bills and insurance premiums. The simple fact is, the more people who have health insurance, the better costs can be contained.

Kansas NEA supports KanCare expansion. It’s good for school employees. Some of the people that our students depend on – bus drivers, cafeteria workers, part time ESP staff – would benefit from expansion. It’s good for children – our students – because learning is very challenging when students must deal with the distress of a sick parent who could be treated with proper coverage.

It’s hard to understand why some legislators are opposed to health care for working Kansans.

The Hensley motion to bring the bill out of committee will take more than the minimum 21 votes – it takes 24 just to get the bill to the floor; it then takes 27 to bring the bill up for action.

In 2017, both the House and Senate voted to expand KanCare only to have it vetoed by Governor Brownback. The House successfully voted to override that veto but the Senate vote to override came up one vote short. This is the same Senate that voted in 2017 with three changes (Eric Rucker for Vicki Schmidt, Kevin Braun for Steve Fitzgerald, and Vic Miller for Laura Kelly). This year, Kansas has a Governor who will sign KanCare expansion into law. The last hurdle is the Kansas Senate.

We urge all Kansans to contact their Senator and urge them to support the Hensley motions to bring HB 2066 to a vote on the Senate floor and then to support HB 2066 for passage. The time for KanCare expansion is NOW. The time to help our rural hospitals, to provide for our working neighbors, to keep our communities strong is NOW.

Take action through the Alliance for a Healthy Kansas (KNEA is a member of the Alliance). Click here.

Want to know more about Medicaid Expansion in Kansas?

To learn more about Medicaid expansion and to watch a short video explaining the “coverage gap,” click here.

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Big issues front and center! Your Action Needed!

Mar 22, 2019 by

House Ed Budget Committee sends two bills to the floor

Two bills were moved out of the House K-12 Budget Committee last night – one dealing with funding, the other with policy. Both bills will now go to the full House for debate next week. And both bills are opposed by KNEA and the education community generally.

But the first action was to deal with SB 142, the Senate’s school finance bill that represents the best response available at this time to the Gannon school finance decision. A motion by Jim Ward (D-Wichita) to pass the bill out favorably was defeated on a 5 to 7 vote – a number which would be repeated several times during the meeting.

Next up was Senate Bill 16 which dealt with naming evidence-based programs that could be paid for with at-risk funds. The bill was brought by Mike O’Neal on behalf of JAG-K (Jobs for America’s Graduates). The Senate added Boys and Girls Clubs to the bill and sent it over to the House.

On a motion by Kyle Hoffman (R-Coldwater), the bill was gutted and a new bill created. House Sub for SB 16 now contains nearly all of the education policy changes sought by House K-12 Budget Committee Chair Kristey Williams (R-Augusta) and the conservative legislators on the committee. There are no funding pieces in the bill at all.

Pieces that were removed from the bill include the bullying task force, the vouchers for targets of bullying, and the restrictions on roofing contracts. The limit on funding bilingual students is changed from four years to five. The 15% cap on unencumbered balances is removed and replaced with an audit of unencumbered balances by the Division of Legislative Post Audit.

The bill still removes the requirement that 92% of the excess costs of special education be reimbursed. It keeps all the new accountability reporting, the study of graduation requirements in the hope of letting financial literacy and computer science count as math or science credits, the establishment of an IT Commission, the extension of the Dyslexia Task Force, and O’Neal’s JAG-K language but without Boys and Girls Clubs. The bill also creates a new bullying hotline.

Also included is a change to the tuition tax credit scholarship (voucher) program that will tend to concentrate vouchers in urban areas. Currently these vouchers are available to students in the 100 lowest performing schools in the state. The change in this bill is to limit the vouchers to the 100 lowest performing elementary schools in the state.

The amendment creating Sub for SB 16 was adopted on a vote of 7 to 5 and the bill was subsequently passed out of committee on a party line vote of 8 to 4.

Sub for SB 16 will do nothing to address the Gannon decision and parts of it could jeopardize equity in our current formula created additional legal problems in the Courts. KNEA opposes Sub for SB 16.

This action was followed by a new Hoffman motion to amend HB 2395, Williams’ school finance plan, to take out all the policy pieces that are now contained in Sub for SB 16.

As amended, HB 2395 (now Sub for HB 2395) would provide about $90 million in new funding but splits that funding essentially half and half between BASE increases and two weightings – a slight increase in at-risk weighting and the creation of new “behavioral health intervention weighting.” The Senate plan in SB 142 would apply the full $90 million increase to the BASE without messing about with a formula that has been deemed to be constitutional.

But there are other very significant and very troubling changes. First, instead of honoring the promises of the 2017 and 2018 school finance actions, this bill repeals entirely the BASE increases in the last two years. SB 142 has all four years funded. This new bill also deletes the current provision that calls for an annual CPI increase to school funding once the Montoy Safe Harbor is reached. Sub for HB 2395 ends all commitments to school funding before reaching the Montoy Safe Harbor and beyond.

If Sub for HB 2395 were to become that Legislature’s response to Gannon, we will likely remain in court far into the future. The best hope for bringing Gannon to an end is to pass SB 142. KNEA opposes Sub for HB 2395.

TAKE ACTION NOW!

Both of these bills (Sub for SB 16 and Sub for HB 2395) will be available next week for debate on the House floor. We urge all supporters of our public schools to contact their state representatives now. CLICK Here to contact your Representative. Ask him/her to vote NO on Sub for SB 16 and Sub for HB 2395 and to pass SB 142 instead. It is time to move a responsible bill to the Supreme Court – that bill is SB 142.

Will the Senate take action on Medicaid expansion?

Thursday, on a vote of 69 to 54, the House passed KanCare expansion, an action that could bring health insurance coverage to as many as 150,000 currently uninsured Kansans. KanCare is the state’s Medicaid program. The expansion is allowed under the Affordable Care Act. The state will pay 10% of the cost while the federal government is required to pay 90%.

Both the House and Senate have voted previously to expand KanCare only to have the action vetoed by then-Governor Sam Brownback. A motion to override Brownback’s veto passed the House but fell a vote short in the Senate.

House leadership has been determined to stop to KanCare expansion but the majority of members have been just as determined to pass it. And on Wednesday, when HB 2066 came to the floor, they got their chance. Kathy Wolfe Moore (D-Kansas City) made a motion to gut the bill and replace the contents with KanCare expansion. This action was necessary because Brenda Landwehr (R-Wichita), the chair of the House Health and Human Services Committee and a hardcore opponent of expansion refused to give a hearing to a bill on expansion.

The amendment was ruled not germane by the House Rules Committee Chair but the ruling was overturned by the members on a vote of 55 to sustain the ruling and 62 to overturn. After a long debate, the Wolfe Moore amendment passed on a vote of 69 to 53 and the bill advanced to final action on a vote of 70 to 54.

Now the bill goes to the Senate but time is almost up for consideration. KanCare expansion is needed in Kansas. We have already seen four rural hospitals close (Independence, Fort Scott, Oswego, and Horton) with many more on the verge of closing. Expansion will help them by paying for more preventative care and limiting the practice of using the emergency room for care. Expansion will help many working Kansans caught in the gap between KanCare eligibility and eligibility for ACA health insurance subsidies. They earn too much to qualify for KanCare but not enough to be eligible to get financial help to buy private insurance.

KanCare expansion will create jobs, protect hospitals and communities, and improve health and financial security for 150,000 Kansans. Here’s what some legislators had to say about why they voted YES on expansion:

  • “I discerningly vote “yes” on HB 2066… Rural hospitals, mental health, and the working poor are losing. While imperfect, today’s decision gives them a chance. Healthcare cannot be solved exclusively in Kansas; let’s resoundingly IMPLORE FEDERAL dialogue, action, and results.” MARK SAMSEL
  • “I vote yes on HB 2066. It ensures that thousands of Kansans can look forward to a healthier and more productive future. And at a time when 86% of Kansas hospitals have negative operating margins, this proposal will provide immediate help for their bottom line, stabilizing operations, aiding in staff recruitment, and providing a lifeline to much-needed retooling and reconfiguring of health care delivery. It has been said that in Kansas a person’s zip code is a greater determinant of health outcomes than genetics. For rural Kansans, HB 2066 gives hope that it need not always be so.” DON HINEMAN, BRAD RALPH, JOHN P. WHEELER, JR., JIM KARLESKINT, SUZI CARLSON, SUSAN CONCANNON, LEONARD A. MASTRONI
  • “Expanding accessibility to preventative healthcare will alleviate crisis health situations, reduce hospital operating losses, and ultimately lead to healthier rural communities. I vote YES on HB 2066.” ADAM SMITH

TAKE ACTION NOW!

CLICK Here to contact your Senator now. Ask them to take action on House Bill 2066 and expand KanCare. It is time to help working Kansans get the health care they deserve; time to step up for our rural hospitals; time to do the right thing. Ask them to call HB 2066 to the floor of the Senate for action.

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