Despite overwhelming public support, Medicaid expansion bill shot down in Kansas

photo by: Sherman Smith/Kansas Reflector

Rep. Brenda Landwehr, a Wichita Republican and chairwoman of the health committee, took action Thursday on a Medicaid expansion bill.

TOPEKA — Republican lawmakers on Thursday brought a Medicaid expansion bill to a halt after one day of discussion, 900 testimonies in support of expansion and dozens of statewide rallies held by Kansans desperate for more health care coverage.

The move will severely limit the chances of the bill’s survival during this year’s legislative session.

Rep. Brenda Landwehr, a Wichita Republican, led opposition to the latest Medicaid expansion bill, encapsulated as House Bill 2556. Landwehr, chairwoman of a House committee that heard the bill, called for action on Thursday after a hearing on the bill on Wednesday. Landwehr was supported in her opposition to expansion by fellow Republican committee lawmakers. The five Democrats and 12 Republicans on the committee voted on party lines.

“But why would you expand a broken system?” Landwehr said, justifying her vote. “I don’t understand that.”

Several committee Democrats said their colleagues deserved a chance to debate the legislation.

“If this bill is so unpopular, give this a chance to have that vote on the House floor, so not just 17 of us will be able to decide this huge of an issue,” Rep. Christina Haswood, a Lawrence Democrat, said.

Medicaid expansion could be reassigned to another committee, inserted into another bill, or forced to the House floor if enough lawmakers throw their support behind expansion.

But that would be unlikely as top Republicans in the House and Senate remain firmly against expansion despite widespread bipartisan support.

Senate President Ty Masterson and House Speaker Dan Hawkins have characterized it as a way to “expand the welfare state,” though most of the estimated 150,000 Kansans who would benefit from expansion are low-income workers or Kansans suffering from chronic illness.

Medicaid expansion would expand state health insurance coverage for lower-income families. Under the Affordable Care Act, the federal government covers 90% of the extra cost of Medicaid services in exchange for expanding eligibility to those at 138% of the federal poverty rate and below.

Medicaid expansion would also unlock $700 million in annual federal funding and could save 59 rural hospitals on the brink of closing. Wednesday was the first time in four years legislative leaders allowed hearings on expanding state health care coverage.

Support for expansion comes from many sectors across the state, including disability rights advocates, health care workers, Kansans without insurance and even the state’s sheriffs, because Medicaid expansion would cover medical costs for people incarcerated in county jails under the bill.

Sedgwick County Sheriff Jeff Easter said the medical costs of caring for inmates could be “devastating,” especially in rural counties. Easter spoke on behalf of the Kansas Sheriffs’ Association Wednesday to voice support for Medicaid coverage in jails as a way to reduce financial burdens for counties.

“We have a lot of sick people that come into the jail,” Easter told committee lawmakers. “We have to, by law, by human standards, provide very good care to these inmates, most of whom have not had care in years. That is becoming extremely expensive.”

House Bill 2556 includes a provision that would provide Medicaid coverage for those who are incarcerated in county jails. The section was added at the request of law enforcement to a governor-endorsed Medicaid expansion bill.

Since the state terminates Medicaid coverage for people in jail — a policy many have called inhumane — people must wait to exit the system to re-enroll. Kansas correctional facilities are mandated to provide medication to people under their custody and Kansas counties shoulder in-facility health care and treatment costs.

In the Sedgwick County Jail, which holds more than 1,500 inmates at times, Easter said several inmates had extremely expensive medical costs. He pointed to one inmate who had been hospitalized 18 times and resulted in a treatment bill of $1,004,588.92.

In another case, an inmate who had been in custody for more than two years was hospitalized 25 times, and the jail was billed for 65 different treatments. Easter said the total cost was around $629,700.

“I use that example, because if you throw that out into the smaller counties, they’d go bankrupt. They have no way to afford that,” Easter said. “When I started as sheriff 12 years ago, our medical budget was $4 million. It is now $9 million and we go over it every year. We simply ask that there is some relief to our local taxpayers on this particular subject, so that those monies can be spent in other ways within our counties.”


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