The fate of Medicaid expansion in Kansas remains undecided – at least until Monday – as supporters of expansion scramble to find votes to override Gov. Sam Brownback’s veto.
Brownback vetoed the proposal Thursday morning, one day after receiving it. “The cost of expanding Medicaid under ObamaCare is irresponsible and unsustainable,” he said in his veto message.
The House immediately began to debate overriding the veto but then paused for the weekend after it became clear supporters would force the chamber to keep a vote open, potentially for hours, while an absent legislator traveled to Topeka.
Kansas lawmakers and Brownback have resisted Medicaid expansion under the federal Affordable Care Act for years. Brownback signed a 2014 law prohibiting the governor from unilaterally expanding Medicaid without legislative approval. But elections last fall changed the atmosphere in Topeka, with a number of new moderate Republicans and Democrats taking seats in the Legislature.
The Kansas Legislature became the first to approve expansion since the failed effort a week ago to repeal the ACA. Expansion proponents and opponents argued over whether Congress may still change the law.
Some 150,000 Kansans could join Medicaid under expansion, supported by the Kansas Hospital Association and several local chambers of commerce across the state. The federal government currently pays for 90 percent of the expansion costs for states that extend Medicaid coverage to people at up to 133 percent of the federal poverty line.
Each chamber would need a two-thirds vote to override the veto.
In the House, 84 votes are needed to advance an override. The House originally passed the bill in an 81-44 vote.
The House debated override for more than an hour on Thursday. Rep. Russ Jennings, R-Lakin, then said expansion supporters would use a parliamentary procedure to keep the vote open for potentially hours in order to allow Rep. Linda Gallagher, a pro-expansion Republican who was absent, to come to Topeka.
But House members voted to pause the debate. They later adjourned until Monday and could resume the override debate then.
If the House votes to override, the motion would move to the Senate. The Senate voted 25-14 to expand Medicaid; 27 votes would be needed to override the veto.
Lawmakers on both sides of the issue will be under extraordinary pressure this weekend from constituents, lobbyists and other lawmakers to either stick to their original vote or to switch.
“When you get to this point, everyone’s pretty well set. Seldom do you see a movement one way or the other,” said Rep. Dan Hawkins, R-Wichita, the House Health Committee chairman.
Whether supporters or opponents of expansion benefit more from the weekend break is an open question.
“I think that’s a good question and it’s certainly one both sides are asking,” Sen. Vicki Schmidt, R-Topeka, said.
Supporters of expansion took to social media to urge citizens to call their lawmakers. The pro-expansion Alliance for a Healthy Kansas said lawmakers could either side with the governor or with their constituents.
“The Legislature has a rare opportunity to make a substantive positive impact in the lives of their constituents and their communities. They should take it and vote to override Brownback’s veto,” David Jordan, the alliance’s director, said.
An opponent of expansion, Rep. John Whitmer, R-Wichita, predicted the vote on a veto override would be close but that opponents would prevail.
“I do think we can sustain (the veto),” Whitmer said.
Affordable Care Act
In his veto message, Brownback said the bill doesn’t meet his three criteria for expansion: that the plan should eliminate a waiting list for disability services, be budget neutral and include a work requirement.
He also said the bill would lead to an increase in funding for Planned Parenthood.
Brownback said it is unwise to undertake “such a drastic change to our Medicaid system” in Kansas while Washington continues work to overhaul the Affordable Care Act.
“Despite lack of Congressional action last week, The White House and House leadership have restarted negotiations on legislation to repeal the Affordable Care Act,” Brownback wrote.
The act allows states to expand eligibility for Medicaid to cover people who earn too little to buy insurance through the federal health care exchange but too much to otherwise qualify for Medicaid.
Rep. Susan Concannon, R-Beloit, rejected Brownback’s argument about federal uncertainty. The Legislature has the opportunity to do the right thing, she said.
“If this isn’t the right time, when is the right time?” Concannon said.
Hawkins opposed the veto override. He said Congress is working on a new plan.
“Obamacare is set to implode,” Hawkins said.
House Minority Leader Jim Ward, D-Wichita, said he was “incredibly disappointed” at the quick veto.
“They’re just cowards,” Ward said. “They’re doing it today in this expedited fashion so they don’t have to hear from the people of Kansas. They know they’re going to get emails and calls. Why do you think the governor expedited his veto? He didn’t want to hear from people who say ‘Don’t veto the bill.’ So he not only broke his word that it was a legislative decision, he did it in a way that the people of Kansas couldn’t weigh in.”