For first time in four years, Kansas lawmakers have hearings on Medicaid expansion

For the first time in four years, Kansas lawmakers held public hearings on Medicaid expansion.

Meeting in the Statehouse's largest committee room, it was standing room only with attendees spilling out into a hallway as senators heard an hour and a half of testimony from supporters and opponents.

The House health committee had a similarly packed room for its hearing on House Bill 2556.

"It's something that our state needs to have a conversation about," said Sen. Carolyn McGinn, R-Sedgwick, who chaired the informational hearing. "The purpose of this meeting is to learn about the pros and cons of Medicaid expansion. Is it good for Kansans? Does it benefit the health of our citizens?"

McGinn said the Senate's health and budget committees had "plenty to read" in additional written-only testimony, of which there were 463 from proponents and three from opponents.

Governor credits more political approach

Kansas entered the 2024 legislative session as one of 10 states that hasn't expanded Medicaid following the 2010 federal Affordable Care Act, though some Republican-led states, notably Mississippi, have considered it this year.

Democratic Gov. Laura Kelly has said Medicaid expansion is her top priority this session, which is her sixth year in a row of attempting to enact the policy.

But Republican leadership in the Legislature is staunchly opposed and have blocked or shut down debate in the past. The last time Medicaid expansion got a public hearing was in 2020, when a plan with bipartisan support was scuttled.

"It's easy to make expansion sound great on the surface but if you dig a little deeper you’ll quickly find that expanding Medicaid to a whole new population of non-disabled, working-age adults will not help Kansas hospitals or patients," House Speaker Dan Hawkins, R-Wichita, said in a Friday newsletter. "Kansas is in a much better place because we've resisted expansion.

"Republicans will continue to stand strong against the immense pressure of the Biden and Kelly administrations. We’ve still got a lot of fight left in us."

Kelly has taken a more political approach this time around, and she credited that for getting the first hearings since 2020.

She formed the Middle of the Road PAC last summer, and it raised nearly $1 million in four months that Kelly said will be used to target legislative races for breaking the GOP supermajorities. The PAC will endorse candidates who support Medicaid expansion, among other policies.

"I think the approach that we took to getting Medicaid expanded is having an impact," Kelly told reporters on Wednesday. "We moved away from what I'd been doing for five years, which is collaborating, working with everybody to come up with a consensus bipartisan bill. Could never get anything, any traction on that.

"So this year, we just took a different tact. They want to make it a political issue, OK, we'll make it a political issue and we'll deal with in a political way. We did that, and it's reaping its rewards."

It is unclear whether the Legislature will act beyond holding hearings. Kelly said she has gotten no indication from leadership on whether they will allow votes.

"So far, we've made it to at least getting hearings," she said. "Obviously, the next step would be getting to debate and a vote on the floor."

Supporters and opponents testify in packed hearings

Christine Osterlund, the state Medicaid director and a deputy secretary at the Kansas Department of Health and Environment, said expansion would benefit low-income Kansans.

Currently, to qualify for Medicaid in Kansas, "You have to be extremely low income," Osterlund said, plus be disabled, elderly, pregnant or a parent of a minor child.

She said an adult qualifies at or below 38% of the federal poverty level. For a single parent with one child, that means $648 a month — or $7,776 a year — is the maximum.

Expansion would increase the limit to 138% while removing the category requirements. For that single parent with one child, that's up to $2,351 a month — or $28,212 a year — to be eligible.

Representing the Kansas Academy of Family Physicians, Quinter doctor Doug Gruenbacher also testified in support.

"For 21 years, I have seen patients who have delayed their care due to the inability to pay," Gruenbacher said. "They have received their primary care in the emergency room due to their inability to pay. They have gone bankrupt due to their inability to pay. They have stopped medications or care due to underinsurance or with a high deductible, and lastly, I have seen patients, they have worked multiple job, part-time jobs, trying to make ends meet, but they just can't be eligible for insurance and they can't get it as an employee benefit."

Sedgwick County Sheriff Jeff Easter, representing the Kansas Sheriffs' Association, said expansion "would be a huge plus" for county jails that have seen rising health costs for inmates in their custody.

"If we would have Medicaid expansion, the cost to our taxpayers would be much, much less — or nothing," he said.

While the fiscal note on HB 2556 predicts the state general fund would save about $184 million over the next two fiscal years, opponents are skeptical.

Sen. Beverly Gossage, R-Eudora, suggested Medicaid expansion would be detrimental to the state budget, is not a "silver bullet for hospitals," it has been a "failure" in "number other states" and leads to job losses instead of promised job increases.

Gossage, who chairs the Senate's health committee and is a health insurance agent, said the people who would benefit from expansion either already get subsidies for private insurance, and they would lose those subsidies and have no real choice except Medicaid.

"Since current Medicaid beneficiaries have difficulty accessing an appointment with a provider, especially a specialist, primarily due to fewer providers accepting Medicaid, adding able bodied adults to Medicaid further strains the already stretched provider network for current Medicaid beneficiaries, causing them to experience even longer wait times," she said.

She urged legislators to reject Medicaid expansion.

"Kansas is wise to preserve limited Medicaid funds for the truly vulnerable for whom Medicaid was originally designed," Gossage said, "and not to displace people from their private plans onto a government program that will stretch the state budget and withhold funds from other vital projects."

Rep. Will Carpenter, R-El Dorado, said his opposition stems from concern for the people waiting for services on the intellectual and developmental disability waitlist.

"My concern is, quite frankly, why would we want to take on another 150,000 folks on our Medicaid rolls when we still have these folks waiting for services already in our state?" he said.

Supporters argue that expansion would benefit people on the waitlist.

Kansas Family Voice and Kansans for Life oppose Medicaid expansion because of the prospect of courts striking down the ban on state funding for abortion.

Jason Alatidd is a Statehouse reporter for the Topeka Capital-Journal. He can be reached by email at jalatidd@gannett.com. Follow him on X @Jason_Alatidd.

This article originally appeared on Topeka Capital-Journal: Kansas Legislature holds first Medicaid expansion hearings since 2020