Medicaid expansion plan advances in the Kansas House

Plan still faces substantial Senate opposition
Medicaid expansion plan advances in the Kansas House
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Supporters of expanding Medicaid in Kansas forced a debate Wednesday in the Republican-controlled Legislature on Democratic Gov. Laura Kelly’s plan and advanced an expansion bill with bipartisan support over GOP leaders’ objections.

The House voted 70-54 to give first-round approval to a modified version of Kelly’s plan for expanding Medicaid health coverage to as many as 150,000 more residents. House members planned to take another, final vote Thursday to determine whether it will pass and go to the Senate, but the debate on it showed that the support for it was solid.

While expansion supporters face a fight in the GOP-controlled Senate, events in the House were a significant victory. Medicaid expansion opponents hold key positions in the House, but 29 GOP members sided with the Democrats in advancing the bill.

That vote followed two earlier ones that allowed expansion supporters to force the debate and replace the contents of a bill dealing with rules for nurses with Kelly’s expansion plan. During a break in the debate, House Majority Leader Dan Hawkins, a conservative Wichita Republican, conceded that the bill ultimately would pass, adding, ” I would say it will change the dynamics. ”

” It was the only way to get this done, ” said state Rep. Kathy Wolfe Moore, a Kansas City Democrat who led the push for the debate and Kelly’s expansion plan. ” The pressure this year came to a crescendo and I think people were demanding it, and they couldn’t ignore it anymore. ”

Three dozen states have expanded Medicaid or seen voters approve ballot initiatives for expansion, including Republican-led Idaho, Iowa, Nebraska and Ohio. The federal Affordable Care Act of 2010 encouraged expansion by promising states that the federal government would pick up the bulk of the extra cost, 90 percent for Kansas if it starts in 2020 as Kelly proposes.

Republicans have argued that Kelly and other expansion supporters are underestimating its potential costs to the state. The House added a provision that ends the expansion within a year if the federal government backs off its promise to cover 90 percent of the additional costs and another charging a $25-per-month premium for each person covered by the expansion, with a $100-per-month limit for families.

Supporters argue that an expansion will help families that cannot afford private health insurance, boost financially struggling rural hospitals and attract $1 billion or more a year in federal funds. They had a rally Tuesday at the Statehouse, hoping to build pressure on top Republicans to allow votes in both chambers.