Republicans expect work requirement to be part of Kansas Medicaid expansion debate

photo by: Nick Krug

Kansas Statehouse in Topeka, February 2014.

Topeka — Republicans expect to consider a work requirement when a Kansas legislative committee begins debating a bipartisan bill for expanding Medicaid, despite opposition to the idea from a GOP leader.

The Republican-controlled Senate Public Health and Welfare Committee plans to start its debate Thursday on a bill containing an expansion plan from Democratic Gov. Laura Kelly and Senate Majority Leader Jim Denning, a Kansas City-area Republican. A final committee vote on the entire bill is expected next week.

Denning acknowledges that work requirements are “a popular idea in Medicaid expansion,” though he and Kelly are urging lawmakers to reject the idea now. Republican legislators — including Denning — imposed work requirements in 2015 for cash and food assistance.

“We’ve got work requirements for other governmental benefits. What’s the difference?” said health committee Chairman Gene Suellentrop, a Wichita Republican.

Suellentrop and other Republicans who support a work requirement argue that it would help Medicaid participants to become self-sufficient. He said arguments against them are “weak.”

“We’re looking at what was modeled in other states,” Suellentrop said.

The Medicaid expansion plan from Kelly and Denning includes a work referral program but not an end to state Medicaid health coverage for able-bodied adults who do not find jobs or go to job training.

Kelly, who was elected governor in 2018 after serving in the Legislature, has long opposed work requirements for social service, arguing that they merely cut off benefits.

But Denning said the proposed Medicaid work referral program would collect data on why Medicaid recipients aren’t working, such as illness or lack of transportation or child care. Kansas should review that information before trying to impose a work requirement, he said.

“It’s a lot easier to be late to the game when you’re talking about something like that,” Denning said. “There’s no reason to be early.”

Thirty-six states have expanded Medicaid. Twenty have pursued a work requirement, but only Michigan has an active one, according to the nonprofit Kaiser Family Foundation. However, no one there is likely to lose coverage for failing to comply for another few months, and the requirement is being challenged in court.

A federal judge in Washington, D.C., has blocked work requirements in Arkansas, Kentucky and New Hampshire. Another six states have requirements that aren’t being enforced or are not yet in effect, and 10 are seeking the federal government’s permission to impose them, according to the Kaiser Family Foundation.

The deal between Kelly and Denning gives Kelly the straightforward expansion of state health coverage that she has advocated to cover as many as 150,000 additional people. Denning would receive a modified version of his proposal to create a new program designed to hold down private health insurance premiums to make it less likely that people would drop their existing private plans in favor of Medicaid.

Denning joined Kelly and advocates for cancer patients at a Statehouse news conference to call on lawmakers to keep the Kelly-Denning bill “clean.” They argued that enforcing a work requirement would be too expensive to administer and would not move enough people into jobs to justify the administrative cost.

“Essentially, the infrastructure that you have to put in place to monitor that is not worth the bang for the buck,” said Dr. Roy Jensen, the director of the University of Kansas Cancer Center.


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