photo by: Nick Krug

Rep. Jim Karleskint, R-Tonganoxie, watches the voting board during a vote on overriding Gov. Sam Brownback's veto of a Medicaid expansion bill, Monday, April 3, 2017 at the Kansas Statehouse in Topeka. The measure failed by three votes. Karleskint voted in favor of the override.

TOPEKA – Democratic Gov.-elect Laura Kelly hopes to push through a Medicaid expansion bill during her first term in office, but she says it may end up looking different from the one lawmakers passed in the 2017 session, which then-Gov. Sam Brownback vetoed.

“I think we need to evaluate that again, given that we’re two years out,” Kelly said in a recent interview.

Under the federal Affordable Care Act, also known as Obamacare, states are allowed to expand their Medicaid programs to cover all individuals in households with incomes up to 138 percent of the poverty level. That’s $16,643 a year for an individual or $28,180 a year for a family of three.

Currently, the Medicaid program in Kansas, known as KanCare, has among the strictest eligibility guidelines in the country. The income limit for adult parents and caregivers is only 39 percent of the federal poverty level, or $7,908 a year for a family of three, and childless adults are not eligible at all unless they are elderly or disabled.

It is estimated that full expansion as allowed under the ACA would extend Medicaid coverage to upward of 150,000 people in Kansas, with the federal government paying at least 90 percent of the cost. Supporters of expansion also argue it would provide much-needed revenue to struggling hospitals across the state, especially in rural areas with high poverty rates.

In 2017, lawmakers passed a bill called the “Bridge to a Healthy Kansas Program” by wide margins – 81 votes in the House and 25 votes in the Senate. That was far more than was needed for passage but just shy of the two-thirds majority needed to override then-Gov. Sam Brownback’s veto.

With Kelly set to take over as governor in January, supporters of expansion no longer need to worry about overcoming a veto. But Republicans are still in firm control of both legislative chambers, and the 2018 elections also produced a more conservative GOP caucus in the House, which could make it difficult to get a Medicaid expansion bill to the floor for a vote.

For that reason, Kelly said she plans to put together a working group to develop a plan that can pass with bipartisan support.

“We’re going to work with the appropriate folks to figure out what that ought to look like, what will provide access to health care, support our rural hospitals, but also that’s doable within our budget,” she said. “Every state’s done it a little differently, and so we will be developing the details of that proposal over time.”

One issue likely to come up in any discussion of Medicaid is a Republican proposal to impose work requirements for able-bodied adults. That was something that current Republican Gov. Jeff Colyer had proposed but that lawmakers, including Kelly, blocked during the 2018 session.

Kelly, however, said she still planned to take a bipartisan approach, not just on Medicaid expansion but throughout her administration.

“I think that people really do trust that this will be a bipartisan administration, that we will work with everybody,” she said.