Medicaid expansion bill advances in Kansas Senate, still faces uphill battle

— A Kansas Senate committee advanced a bill Monday that would expand the state’s Medicaid program to extend coverage to an estimated 145,000 additional Kansans.

But even though there was no vocal opposition in the committee, supporters admit the bill still faces a number of obstacles, including opposition from Republican leaders in the Senate, as well as from Gov. Jeff Colyer, who has been an ardent opponent of expanding Medicaid.

“We may end up having to use a procedural technique to get it (to the floor of the Senate),” Sen. Laura Kelly, D-Topeka, said in an interview after the committee vote.

Under Senate rules, if leadership refuses to put a bill on the debate calendar, the full body can force the bill onto the calendar with a two-thirds majority vote — the same majority needed to override a veto.

Thursday marks the so-called “turnaround” deadline for the House and Senate to pass most of their own bills and send them to the other chamber, although Senate leaders have already invoked a procedure to exempt the Medicaid expansion bill from that deadline. Typically, it is up to the leadership in each chamber to decide which bills will come up for votes and which ones may be left to die after the deadline.

A similar bill passed both chambers of the Legislature in 2017, but it was vetoed by then-Gov. Sam Brownback, and it died when the House fell three votes short of the two-thirds majority needed to override that veto.

In the Senate, last year’s bill received 25 votes for passage, two votes shy of a two-thirds majority. Among those voting no were Majority Leader Jim Denning, R-Overland Park, who controls what bills go on the Senate debate calendar, and Senate President Susan Wagle, R-Wichita.

Committee Chairwoman Sen. Vicki Schmidt, R-Topeka, wouldn’t predict whether Denning would allow debate on the bill.

“That is not in my control,” Schmidt said in an interview. “My job as a committee chair is to move bills to the Senate floor, and then it’s up to the majority leader on the disposition of the bill.”

Denning told reporters Monday he does not intend to allow any debate on Medicaid expansion until after the Legislature passes a long-term fix to the state’s school finance system, and that fix is approved by the Kansas Supreme Court, something that could take until after lawmakers adjourn the 2018 session.

The bill that passed Monday out of the Public Health and Welfare Committee is similar to the one lawmakers considered last year. Among other things, it would require most able-bodied adults in the expansion group to work at least 20 hours a week or be referred to a job-training program.

Under the federal Affordable Care Act, also known as Obamacare, the federal government would pay 90 percent of the cost of insuring those people who become newly eligible under the expansion. For people in traditional Medicaid, the federal government currently pays only about 55 percent of the cost.

Supporters of the Senate bill, however, say it is designed to have no net cost to the state. That’s because it is expected to result in additional revenues to the state through higher rebates on pharmaceuticals. It also would result in an increase in revenues from the privilege fee charged to the private insurance companies that manage the state’s Medicaid program, known as KanCare.

Even Kelly, however, conceded that passage of the bill would probably result in increased costs to the state.

“I think the fact of the matter is, when you expand a program like this, that we’ll be picking up some additional costs,” she said.

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