Kansas Senate sends Medicaid expansion bill to Brownback

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? With nearly a veto-proof majority, the Kansas Senate voted 25-14 Tuesday to send to Gov. Sam Brownback a bill to expand Medicaid under the Affordable Care Act, a program that President Donald Trump and Republicans in Congress tried and failed to repeal last week.

The bill earlier passed the House with 81 votes, three fewer than the 84 needed for a veto override.

The Kansas Health Institute estimates passage of the bill would extend Medicaid coverage to an estimated 152,000 Kansans, including about 54,000 children. A little more than half of those are currently uninsured. KHI estimates about 71,000 people who would become eligible already have some form of insurance but would switch to Medicaid if given the chance.

The Kansas Department of Health and Environment says the expansion would cost the state roughly $81 million in the upcoming fiscal year.

“This is not a good investment for Kansas at this time,” said Sen. Caryn Tyson, R-Parker, who chairs the Senate tax committee.

But supporters of the bill have argued that the state’s cost would be offset because the bill would also increase employment throughout the health care industry in Kansas.

“Expansion also means rural hospitals, clinics, mental health centers and other health care providers remain open by reducing the cost of uncompensated care,” Senate Democratic Leader Anthony Hensley, of Topeka, said, explaining his vote in favor of the bill. “Further, it creates more than 3,800 new jobs.”

Although the Senate came up two votes short of a two-thirds majority, supporters of the bill said they remain hopeful that they can sway at least two senators to switch their votes to override a veto.

Even if a veto is sustained, though, Tuesday’s vote still signifies the huge political shift that the 2016 elections produced in the Legislature and the weakened position in which Republican Gov. Sam Brownback now finds himself.

It was the second time this session that the Legislature has voted by near veto-proof margins to reverse or overturn one of Brownback’s signature policy positions. The first was a $1 billion income tax bill that would have reversed many of the tax cuts he championed in 2012.

The Affordable Care Act, commonly known as Obamacare, was enacted in 2010 when Brownback was still serving in the U.S. Senate. He was a vocal opponent of the bill at that time, and he has remained staunchly opposed to the program since then.

During his first six years as governor, there was a solid conservative majority in the Kansas House, and he personally helped engineer a conservative takeover of the Senate during the 2012 elections. But Brownback’s own popularity began to wane after he pushed through sweeping income tax cuts, which his critics say were the primary cause of the state’s worsening financial condition.

By 2016, the political winds in Kansas had shifted, and in the elections that year Democrats and moderate Republicans made big gains in both chambers, enough to form large majorities willing to undo many of his tax cuts and push through an Obamacare expansion of Medicaid.

Meanwhile, lawmakers are still expected to pass some sort of income tax overhaul this year, with the two-thirds majorities needed for a veto override, that will likely undo at least some of the tax cuts Brownback pushed through in 2012.