Kansas would expand state health coverage for the poor and disabled in line with the federal health care act but would tax hospitals and clinics to raise any state dollars needed to attract extra federal funds under a proposal outlined Monday by a legislative panel.
The measure sponsored by the state House Vision 2020 Committee would allow Kansas to require able-bodied Medicaid participants to hold jobs or volunteer positions to receive coverage. The state also would be able to charge premiums for coverage.
The committee is unusual in the Republican-controlled House because it’s not dominated by GOP conservatives, and its chairman, Rep. Tom Sloan of Lawrence, is more liberal than other Republicans. There is still strong opposition among top Republican legislators to expanding the state’s $3 billion-a-year Medicaid program, which provides health coverage to about 368,000 people.
Sloan said the committee’s proposal, which would expand coverage to 169,000 more people, is designed to address the reasons many GOP legislators give for opposing a Medicaid expansion.
Hospitals have endorsed an expansion and said they would support a new tax to draw down federal dollars. The bill would allow the state to tap them for a total of $327 million over five years.
“It is an attempt to balance the political realities,” Sloan said.
A legislative committee in Tennessee last week rejected a plan from popular Republican Gov. Bill Haslam to expand Medicaid there that emerged from nearly two years of negotiations with the federal government. But Indiana, led by conservative GOP Gov. Mike Pence, recently expanded coverage under a federally approved plan that includes health savings accounts.
The federal government promises to pay the full cost of a state’s Medicaid expansion through 2016 and at least 90 percent after that.
Gov. Sam Brownback has said he’s open to proposals to expand Medicaid, which is now barred by state law. But he and other top Republicans question whether Kansas could raise any matching funds.
The state is facing a projected shortfall of nearly $600 million in its budget for the fiscal year beginning July 1 after lawmakers aggressively cut personal income taxes at Brownback’s urging in 2012 and 2013 to stimulate the economy.
And some GOP lawmakers want Kansas involved as little as possible with the 2010 federal health care law championed by President Obama, viewing it as burdensome and harmful to the economy.
“Only rats get caught in rat traps,” said Senate Majority Leader Terry Bruce, R-Nickerson.
Medicaid in Kansas doesn’t cover able-bodied adults without children, and many parents aren’t covered unless their incomes fall well below the federal poverty level.
Meanwhile, the federal health care law provides insurance subsidies for families who make one to four times the federal poverty level. The poverty level is $15,730 for a family of two and $23,850 for a family of four.