Kansas’s hardline opposition to Medicaid expansion has to change, if health care and health outcomes are going to grow in rural Kansas. Given the governor’s position, and a bill (HB 2552) passed in 2014, that change will have to begin in the Kansas Legislature. A change in the Republican moderate-conservative power distribution coupled with some pick-ups in Democratic seats this November could provide the legislative majority required by HB 2552.

A harbinger of that change is the serious challenge being given to Republican State Representative Ron Highland of Wabaunsee County who is facing a young, well-funded, and skillfully organized challenge from Rossville, Democrat Adrienne Olejnik. Similar changes in Johnson County and other districts around the state also seem more likely come November 8.

The Medicaid problem got a pretty good airing through announcements made recently by Stormont-Vail, a big health care provider in northeast Kansas. Stormont-Vail and its Cotton-O’Neil division announced the closing of two clinics open for less than 18 months. Stormont-Vail CEO Randy Peterson attributed the closings of the Cotton-O’Neil clinics in Alma (Wabaunsee County) and Lyndon (Osage County) to two things. First, the state’s recent decision to cut Medicaid reimbursements by 4 percent. Second, the unsparing determination of the governor, endorsed by earlier legislative resolutions, not to accept additional Medicaid money to serve 150,000 Kansans who earn more than the state’s stingy 38 percent of poverty Medicaid benefit qualification, but less than $30,000 a year for a family of four.

The reimbursement reduction alone cut $3 million from Stormont-Vail’s revenue, and the closings have negatively impacted 2700 clients in northeast Kansas. Not all of that now unserved clientele uses Medicaid. Many are simply average townspeople and farm families, or elderly residents who will now have to find alternatives. State action (and inaction) has made service for all by the health care provider economically impossible.

Representative Highland has been a supporter of the hardline anti-Medicaid position.

Since the purge of moderate Republican legislators began in earnest in 2012, the Legislature has gone on record several times to make clear its solidarity with the governor in opposing Medicaid.

In 2014 the Legislature attempted to take away any existing or subsequent executive authority to expand Medicaid by enacting HB 2552. The bill explicitly required a legislative enactment before any expansion of Medicaid beyond the current stingy limits can occur. HB 2552 passed the Kansas House 68 to 54 and the Senate 33 to 7. It was signed by the governor in the last days of the 2014 session

The tea leaves do not foretell a veto-proof Legislature’s election. If that doesn’t happen then Kansas can continue to deny expanded Medicaid supported health care for 150,000 uncovered Kansans. Whether that proves to be the case or not, it should provide a valuable civics lesson to an electorate that may be turned off by the ugliness of the national electoral scene this year.

It is important to remember that races like the Highland – Olejnik contest actually matter far more to the daily lives of Kansans. Do not forget that voting will determine government’s actions which will affect the lives of real people in real ways.

— Mark Peterson teaches political science at the college level in Topeka.