Virginia passed Medicaid expansion. Could Kansas finally do the same?

When former Kansas Gov. Sam Brownback vetoed legislation that would have expanded Medicaid, he claimed his reasons for rejecting health care coverage for the poor were that it would be fiscally irresponsible and would still fund Planned Parenthood.

I believe the underlying reason was something else, likely the real objection that conservatives whisper to one another: Able-bodied men and women who do not work should not receive more handouts.

That argument can be neutralized, however, if Kansas copies what Virginia lawmakers just passed. In Virginia, a GOP-controlled legislature approved Medicaid expansion with important caveats that have now become law.

The legislature put in some tough new restrictions affecting all Virginia Medicaid recipients, present and future. From now on, adult recipients of Medicaid without disabilities must either work or volunteer as a condition for receiving Medicaid. That was the critical provision that put the expansion over the top.

Virginia is now the 33rd state to expand Medicaid. Meanwhile, Kansas and Missouri are among the remaining 17 states denying broader coverage, even though under the Affordable Care Act, 90 percent or more of the additional cost is paid for by the federal government.

To say expansion of KanCare — the Kansas name for its privatized Medicaid system — is fiscally irresponsible is absurd, even though that argument is repeated like a mantra among conservatives. Opponents claim that paying even 10 percent of the additional annual cost for the state is too much.

But it’s not. After 2020, the state’s annual cost to cover 150,000 uninsured Kansans has been estimated at about $27 million, out of a $6.6 billion general fund budget. To turn away billions of dollars in federal revenue is what’s fiscally irresponsible.

While tens of thousands of the uninsured live right here on the Kansas side of the metropolitan area, the near-fatal pain is being felt out in rural Kansas. There, hospitals are struggling to stay alive and desperately need the additional Medicaid revenue to help cover treatment of the uninsured. Those hospitals may be far away from where we live, but we cannot stand by and allow these vital community health facilities to close, as some already have.

Unlike past failed efforts, this bill to expand succeeded due to an odd alliance between the more moderate urban legislators, many of whom were elected in the last election, and a block of rural lawmakers trying to help out their poor constituents and the hospitals that serve them.

They shocked the nation in 2017 when they cobbled together a slim majority to expand Medicaid in the red state. Unfortunately, they were a few votes shy in the House to override Brownback’s veto.

Kansas Gov. Jeff Colyer, who is a Republican contender in the race for governor, has ducked the question of whether he would sign or veto legislation expanding KanCare. In the past, Colyer, who was the chief architect of the privatized health care system for the poor in Kansas, has opposed expansion. But perhaps the new constraints outlined in Virginia could change his mind.

At this time, Colyer will not commit one way or the other while facing Kansas Secretary of State Kris Kobach, who is the other leading GOP candidate for governor. Kobach undoubtedly would be more than willing to veto expansion of health care for the poor.

That callousness is right up his alley and appeals to his conservative base. They love to hate Obamacare, even if it means denying 150,000 Kansans health care coverage, paid for almost entirely by federal funds.

Of course, what Colyer and Kobach and other conservatives think about Medicaid expansion may be a moot point. The next Kansas Legislature may pass a Medicaid expansion bill, again over howls of protest. But this time, the bill may very well be handed to a Democratic governor to be signed into law.

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