Kansas House panel begins hearings on Medicaid expansion

At a packed hearing Wednesday, Kansas lawmakers weighed whether to expand Medicaid, which could give health care coverage to an estimated 150,000 uninsured Kansans.

HB 2319 would raise the threshold for Medicaid coverage to 138 percent of the state’s poverty line, which translates to an annual income of $32,500 for a family of four. That would give coverage to more than 150,000 people, according to the Kansas Health Institute, which submitted an analysis of the bill.

“With one stroke, you could reduce the number of uninsured in this state by almost a half,” said Jerry Slaughter, a physician testifying on behalf of the Kansas Medical Society in support of the bill.

The Affordable Care Act granted states the authority to expand Medicaid, which provides health coverage to poor and disabled Kansans. The federal government would fund 100 percent of the costs through 2016, then down to 90 percent by 2020.

The future cost to the state has been a hurdle to expanding Medicaid in the past two sessions, as has the connection to President Obama’s Affordable Care Act in the Republican-controlled Legislature.

But supporters are more optimistic this year about a proposal crafted by the Kansas Hospital Association. It integrates ideas from other Republican-led states that have expanded Medicaid, such as incentives for healthy behavior and a provision that allows a state to drop out if federal funding dips below 90 percent.

The state privatized its Medicaid system under the KanCare umbrella during Gov. Sam Brownback’s first term, supporters noted.

Practical matters

Slaughter told lawmakers they could argue about the philosophy, but as a practical matter, they have decide how to support the state’s health care infrastructure. He said this is a way to do that.

Rep. Jim Kelly, R-Independence, a member of the House Health and Human Services Committee, noted that many rural hospitals are stressed financially and expressed his worry that hospitals in Montgomery County might have to close if the state doesn’t expand Medicaid coverage.

Rep. Tom Sloan, R-Lawrence, who testified in support of the bill, said that as of Wednesday morning, the state had missed out on about $474 million by not expanding Medicaid. He and others argued that Kansans had already paid for expansion through their own tax dollars and that the state is letting that money go elsewhere.

Opponents, such as Americans for Prosperity, which has links to Wichita-based Koch Industries, will testify against the policy on Thursday at a second hearing before the health committee.

Jeff Glendening, Americans for Prosperity’s state director, said the organization has concerns about the costs once the state must begin chipping in after 2016.

“The extreme cost when you’re providing coverage to able-bodied Kansans – we just can’t afford it. We’ve got financial problems right now, and expanding Obamacare is not something we should be doing,” Glendening said.

The Kansas Department of Health and Environment will present testimony about projected costs on Thursday.

Full hearing

Many supporters saw the fact that the health committee even held a hearing as a sign of progress compared to previous sessions. The hearing was so full that many of the bill’s supporters had to sit outside and listen from the hallway.

Sonja Willms, a Hoyt resident who listened from the hallway, wore a homemade T-shirt that said “Medicaid Saves Lives.” She said she was speaking about herself.

“I wouldn’t be here. I’m not exaggerating; I literally do not think I would be here,” said Willms, who has Medicaid coverage for disabilities resulting from diabetes. She had kidney and pancreas transplants just this year, she said, which she would not have been able to afford without Medicaid. “I take at least 30 pills a day. Half of them run $2,000 to $4,000 a month.”

Inside the committee room, physicians, patients and representatives from the business community made their case to lawmakers.

Bryan Brady, who runs the First Care Clinic in Hays, told lawmakers that Medicaid expansion would help encourage some people to go back into the workforce.

“You might say, ‘What am I talking about?’ Well, what about a parent who’s on KanCare right now and has children at home to worry about so they have to worry about their own health care and staying healthy?” Brady said. “The moment they go back to work or they start working, they make too much income to qualify for KanCare. And so we pull the rug out from under them. We pull them halfway up, and we let them fall again.”

Steve Kelly, CEO of the Newton Medical Center, noted that 70 percent of the people who would benefit from expansion have jobs but can’t afford insurance. He compared the expansion to the economic development benefits the state offers new companies.

Kelly had previously chaired the governor’s KanCare advisory council.

Marcilene Dover, a 21-year-old Wichita resident, told the committee about when she was diagnosed with multiple sclerosis but did not have insurance to cover treatment costs. Dover said that no one should have to suffer a devastating diagnosis and then endure the further devastation of not knowing how to pay for it.

She receives treatment through the nonprofit Project Access, which connects uninsured people with specialty care. She noted that the organization recently had its funding reduced by Sedgwick County.

Emotional testimony

After the hearing, Rep. Barbara Bollier, R-Mission Hills, a physician and one of the few Republicans who has vocally called for expansion in recent years, said she thought some of her GOP colleagues were swayed by the testimony.

“I cannot imagine that they could not have been. … This was an incredible presentation. And to hear the sheer numbers of people in this state and to look at the people wishing to testify to show their support, Kansans have spoken,” Bollier said. “They want this.”

Rep. Dan Hawkins, R-Wichita, the committee’s chairman, called the meeting emotional and said he was impressed by the information proponents offered. However, he wouldn’t say whether he was swayed.

“The one thing that they really didn’t talk about a whole lot is the cost. And the cost is so important … but I don’t think anybody has a heart out there that wouldn’t feel for the people that need the help,” Hawkins said. “We all feel for them. It’s how do we finance that.”

Rep. Melissa Rooker, R-Fairway, said Tuesday she expects the Medicaid legislation to be used as a bargaining chip as lawmakers have to make tough votes on budget and tax issues.

“I’m very hopeful that this is a serious effort in the health committee to have a hearing, work the bill and bring it out to the floor so we can consider the pros and cons based on its merits,” Rooker said. “But my fear is it will get caught up in negotiations of other issues this session, primarily tax and budget.”

This story was originally published March 18, 2015 at 6:32 AM with the headline "Kansas House panel begins hearings on Medicaid expansion."