Medicaid expansion bill introduced in Kansas House

? A bill to expand the state Medicaid program has been introduced in the Kansas House, but lawmakers may have to rush in order to pass it before the Republican-controlled Congress repeals the federal Affordable Care Act that makes the expansion possible.

In fact, while supporters believe the idea has more than enough support to pass the 125-seat Kansas House, all of whose members were just elected in November, the state’s entire delegation in the U.S. House is on record supporting repeal of the federal law, even though they were all re-elected on the same ballot.

“What we heard during the campaign season was that there are a lot of Kansans who want us to talk about this,” said Rep. Sue Concannon, R-Beloit.

Concannon, who asked for the bill to be introduced, is vice chair of the Health and Human Services Committee that is scheduled to hold hearings on it in early February.

Last week, both chambers of Congress took initial steps toward repealing the Affordable Care Act, commonly known as Obamacare. Three of Kansas’ four U.S. House members and both of the state’s senators voted in favor of the measure.

“Today, I joined my House colleagues in taking the first step in repealing the president’s flawed health care law and transitioning to a patient-centered health care system,” said Rep. Lynn Jenkins, who represents the 2nd District of eastern Kansas, including Lawrence.

Also voting in favor were Reps. Kevin Yoder, of Overland Park, who represents the 3rd District, and Roger Marshall, of Great Bend, who represents the 1st District.

Fourth District Rep. Mike Pompeo, who has been nominated to become the next CIA director in the Trump administration, did not vote but has said in the past that he supports repealing the Affordable Care Act.

“Canceled policies, difficulties in identifying new plans, massive premium increases, sky-high deductibles and limited options for doctors — the new normal for many American families under Obamacare,” Sen. Jerry Moran said in a statement Thursday after the Senate vote. “This vote gives us the opportunity to begin repairing the damage.”

Gov. Sam Brownback also spoke out against expanding Medicaid, known in Kansas as KanCare, during his State of the State address Jan. 10.

Kansas Rep. John Wilson, D-Lawrence, the ranking Democrat on the committee that will hear the expansion bill, said he believes there is a disconnect between Topeka and Washington.

“I think our congressional delegation, by and large, seems to want to put ideology over the practical policies that help people’s lives,” Wilson said.

Wilson also said he’s not confident that Congress will be able to repeal the federal law quickly.

“We’ve never relied on the federal government to act swiftly, so I don’t know why we’d suddenly pretend it now,” he said. “I think regardless of what the incoming administration decides to do, we need to at least have a thorough discussion about the needs of 150,000 Kansans who don’t have health insurance, and we need to get a sense of what it would cost us should we want to provide coverage for them if it’s in a different form than under the Affordable Care Act.”

Wilson also said he believes the bill has enough bipartisan support to pass out of the Kansas House.

Currently, Kansas has one of the strictest eligibility requirements for Medicaid of any state in the country. It is available only to pregnant women, children, disabled adults and seniors who meet certain income guidelines, typically between 100 and 150 percent of the 2016 federal poverty level.

For working-age parents and caregivers, the income guidelines are much stricter: $7,644 per year for a family of three, or 38 percent of the 2016 federal poverty level.

Childless adults under age 65 are not eligible for Medicaid in Kansas.

The bill would expand eligibility to all adults under age 65 with incomes up to 133 percent of poverty level, or $26,720 a year for a family of three. Under the Affordable Care Act, as it currently stands, the federal government would pay 90-95 percent of the cost of insuring those people in the expansion group.

The bill also authorizes the Kansas Department of Health and Environment to refer any adult in the expansion group who is unemployed or working fewer than 20 hours per week to a workforce training program or work-search resources, but it would not impose a specific work requirement on individuals, nor would it charge them a premium for the insurance.

It is estimated that full expansion of Medicaid would extend coverage to about 150,000 Kansans who currently don’t have health insurance.

Concannon said she introduced the bill on behalf of the Kansas Hospital Association, which has been a strong supporter of Medicaid expansion since the Affordable Care Act was passed.

Medicaid expansion is only one of the ways the Affordable Care Act was supposed to make health coverage universal in the United States. The act also required employers with more than 50 workers to provide their employees with coverage that meets certain standards.

And people with incomes above the new Medicaid threshold who don’t have access to or cannot afford employer-sponsored coverage can buy subsidized insurance through web-based markets known as exchanges.

According to the U.S. Department of Health and Human Services, 96,304 people in Kansas have signed up for coverage through the exchange markets for 2017.