photo by: Tim Carpenter/Kansas Reflector

Christine Osterlund, the Kansas Medicaid director, opens a Kansas Senate hearing Wednesday on benefits and disadvantages of expanding eligibility for Medicaid statewide.

TOPEKA — Kansas lawmakers, health care advocates and lobbyists packed two committee rooms Wednesday, wearing buttons and slogan-emblazoned shirts to show support for Medicaid expansion.

But that may fall on deaf ears, as several key lawmakers remain against expansion, leaving the proposal’s fate uncertain.

Rep. Brenda Landwehr, a Wichita Republican, is chairwoman of a House committee that heard the latest Medicaid expansion bill, House Bill 2556, Wednesday afternoon. Landwehr said she remains opposed to expansion but could not predict what the committee would decide. With five Democrats and 12 Republicans on the committee, a vote along party lines would kill the bill.

Committee action is expected soon.

“It could be tomorrow,” Landwehr said.

More than 900 written testimonies were made in support of Medicaid expansion, according to the governor’s office.

“Kansans across the state have overwhelmingly echoed the same message — they want Medicaid expansion,” Gov. Laura Kelly said. “While the legislature has held hearings, it cannot stop there. The Cutting Healthcare Costs for All Kansans Act must swiftly be debated on the floor and put up to a vote.”

The meeting, one of two on Medicaid expansion held Wednesday, was the first time in four years that legislative leaders have allowed hearings on expanding state health care coverage.

Kansas is one of 10 states left that have not expanded, and Republican leadership in the Legislature — where the party holds a supermajority in both chambers — has blocked expansion despite widespread public and legislative support.

Kelly has spent months rallying across the state for expansion, leveraging 2024’s election year status to jolt Kansas lawmakers into action before they face their constituents in the fall. With Kelly’s backing, Democrats introduced Medicaid expansion bills into House and Senate committees in January.

They waited until now for action.

Landwehr said the time was right to have committee discussion on the bill. A joint Senate committee informational hearing on expansion was heard earlier, on Wednesday morning.

“We thought, ‘OK, let’s have the debate, let’s have the discussion,'” Landwehr said.

photo by: Tim Carpenter/Kansas Reflector

An overflow crowd attended a Kansas Senate hearing Wednesday on Kansas expanding Medicaid to about 150,000 lower-income adults and children. It was to be followed by a Kansas House committee hearing on Democratic Gov. Laura Kelly’s Medicaid expansion bill.

In both meetings, several Republican lawmakers, including Sen. Beverly Gossage, a Eudora Republican, spoke against expansion, arguing the current state health insurance plan should not be changed.

“For multiple reasons, I urge my fellow legislators to vote against Medicaid expansion,” Gossage wrote in submitted testimony. “Kansas is wise to preserve limited Medicaid funds for the truly vulnerable for whom Medicaid was originally designed. And not to displace people from their private plans onto a government program that will stretch the state budget and withhold funds from other vital projects.”

Under the Affordable Care Act, the federal government covers 90% of the extra cost of Medicaid services in exchange for expanding eligibility to 138% of the federal poverty rate. Medicaid expansion would unlock $700 million in annual federal funding and could potentially save 59 rural hospitals on the brink of closure.

Among the conservative national lobbying groups that voiced opposition to expansion were Americans for Prosperity, the Cato Institute and Opportunity Solutions Project.

Dean Clancy, senior health policy fellow with Americans for Prosperity, said expansion would take away funds from “truly needy patients.”

“Every Medicaid dollar that the state spends on able-bodied adults is one less dollar it can spend on individuals with disabilities, pregnant mothers, and children in poverty,” Clancy said. “States that expand Medicaid have fewer resources to treat truly needy patients.”

Most of the estimated 150,000 Kansans who would benefit from expansion are low-income workers or those suffering from chronic illness.

Benjamin Anderson, president and CEO of Hutchinson Regional Healthcare System, a Republican who was “raised to believe that every person is created by God with equal, inherent value,” said he supported expansion, partially due to his experience watching the rural hospitals in his areas suffer.

Christine Osterlund, the Kansas Department of Health and Environment’s deputy secretary and the state’s Medicaid director, said increasing access to affordable health care would result in more Kansans receiving preventative health care, addressing health issues before they worsen and result in hospitalization or emergency room visits.

“Expansion states show more mothers accessing services, including postpartum care, than in non-expansion states, and children with parents enrolled in Medicaid are more likely to receive health care services,” Osterlund said. “Eligible individuals with behavioral health conditions see increased access to behavioral health treatment and other services under Medicaid expansion.”