Politics & Government

Kansas governor, Senate GOP president face off over Medicaid

As Kansas Gov. Laura Kelly urges lawmakers to expand Medicaid, the state Senate’s top Republican is opening the door to a health care bill that would include provisions favored by conservatives, such as work requirements.

But Senate President Susan Wagle wants the Legislature to study expansion later this year and take up a bill in 2020. She made clear Tuesday that – as far as she’s concerned – a Medicaid expansion bill that passed the House last month won’t survive the Senate.

“The governor just called for the Senate to pass a bill that Bernie Sanders – a socialist – endorsed. And that’s not going to happen in the Kansas Senate,” Wagle said.

Kelly, who has made expansion her signature issue, said in the expansion debate the term “study” has come to mean “stall.”

“Enough is enough. No more stall tactics. No more bait and switch. No more excuses,” Kelly said Tuesday.

Turning up the pressure on lawmakers, Kelly said she wants the Senate to vote on expansion by the end of the week. That’s when the Legislature will begin a break expected to last until May – leaving Kelly’s signature issue in limbo.

The House vote to approve expansion in March attracted national attention. Sanders, a Democratic presidential candidate, called it a “major step.” But since then, the Senate hasn’t taken action on the legislation.

Expansion supporters likely have enough votes to pass the plan if it comes up for debate. However, Republican leaders wield significant control over what bills make it to the floor – making it difficult for supporters to force a vote.

The showdown between Kelly and Wagle is the latest flashpoint in a years-long struggle by expansion supporters to make Medicaid – and its health coverage – available to upwards of 100,000 Kansans.

The basic shape of the debate in Topeka over expansion has remained unchanged for years.

If Kansas increases eligibility in the program, which provides health coverage to low-income individuals and individuals with disabilities, to 138 percent of the federal poverty level, then the federal government will pay for 90 percent of the cost. For a family of four, that’s $35,535 a year.

The state’s share of the cost of expansion has been estimated at somewhere between $34 million and $47 million a year.

But under President Donald Trump, the federal government has begun allowing states more control over how they craft expansion. The Centers for Medicare and Medicaid Services in March allowed Utah to expand Medicaid up to 100 percent of the federal poverty level, instead of the 138 percent typically required.

The federal government has also signed off on work requirements for Medicaid recipients. However, a federal judge blocked work requirements in Kentucky last week.

“We want to put caveats in that (the federal government) is approving. We want time to look at those,” Wagle said.

Wagle’s call to take the next few months to develop a new health care plan may be attractive to some Republicans who supported Medicaid expansion in the past.

Sen. Rick Wilborn, a McPherson Republican, voted for expansion in 2017 because of the rural hospitals in his district. On Tuesday, he said Senate leaders are determined to draw up a plan and he mentioned Utah’s expansion that limits eligibility to 100 percent of the poverty level as the type of idea that could help mitigate the budget effect of expansion.

“I think the Senate leadership will come up with a Kansas-customized product,” Wilborn said.

Democrats are skeptical of Wagle’s intentions. Senate Minority Leader Anthony Hensley, a Topeka Democrat, said Wagle’s comments amount to an effort to keep the Legislature from passing expansion this year.

“I think it’s just a delay tactic for fear that if the bill would ever come to the Senate floor, it would actually pass,” Hensley said.

Kelly campaigned on Medicaid expansion and has expressed hope that the Legislature will pass it during her first session in office. But the clock is counting down.

Once lawmakers leave Topeka at the end of the week, they won’t return until May 1. After that, there’s no guarantee how long they’ll remain in session.

Kelly said Tuesday that she has had conversations with legislative leaders, but that they hadn’t progressed much beyond each side stating its position.

While Kelly rejected the idea that lawmakers need to study Medicaid expansion and wait to act in 2020, she said she would view a study during the April break as progress.

“I would prefer that they act on it this week and they get it done before they go home,” Kelly said. “But in lieu of that, I’d take that compromise.”

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