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.