Local lawmakers weigh in on Medicaid expansion issue, as movement on the issue announced in Topeka

Wyandotte County legislators expressed their opinions on issues at a town hall meeting on Wednesday night at the West Wyandotte Branch Library, 1737 N. 82nd St., Kansas City, Kansas. (Photo by Mary Rupert)

Kansas legislators from Wyandotte County expressed their opinions on Medicaid expansion and other issues at a town hall meeting on Wednesday night at the West Wyandotte Branch of the Kansas City, Kansas, Public Library, 1737 N. 82nd St.

On Thursday morning in Topeka, Gov. Laura Kelly announced a compromise agreement between Democrat and Republican lawmakers on a Senate bill on Medicaid expansion. A Medicaid expansion bill passed the House last year.

The town hall meeting was one of several held each year by the Wyandotte County legislative delegation. More than 50 people attended Wednesday.

At the Wednesday night town hall meeting, State Sen. David Haley, D-4th Dist., and State Sen. Pat Pettey, D-6th Dist., were in favor of Medicaid expansion, while State Sen. Kevin Braun, D-5th Dist., expressed some reservations about it.

State Sen. David Haley, D-4th Dist., who was at the governor’s announcement in Topeka, said on Thursday he was very excited about the agreement on the Medicaid expansion bill.

“The bill is a tremendous opportunity to expand Medicaid to a fragile population ithout further impediment,” Sen. Haley said.

Republican and Democratic leadership were in agreement, and the bill has a very good chance of passing, he said.

Sen. Haley said it’s possible that around 15,000 Wyandotte County residents could have health insurance through Medicaid because of this bill. Statewide, about 150,000 Kansans could be eligible, he said. People who are up to 138 percent of the federal poverty guidelines would be eligible under the bill.

Many of these are people who are working but who cannot afford to pay for health care, he said, and who do not fit under the current Medicaid guidelines or cannot afford insurance through the Affordable Care Act. They fall into a gap between making too much money to qualify for Medicaid, but not making enough money to afford insurance.

Ninety percent of expanded Medicaid funding would come from the federal government, while 10 percent would come from the state of Kansas, he said.

There is no work requirement for recipients in the bill announced Thursday, although a work requirement was mentioned previously by some conservatives, Sen. Haley said.

“The Wyandotte County delegation, I would hope, would be hard-pressed to continue to deny expanded coverage to our citizens,” Sen. Haley said.

State Sen. Pat Pettey, D-6th Dist., served on the governor’s committee on Medicaid expansion.

Sen. Pettey said on Wednesday that she was a strong supporter of passing Medicaid expansion this year.

She also supported education funding, and mentioned that she believes health and education are tied together. If the community doesn’t continue to look at how to raise education levels, it will continue to be among the least healthy counties, she said. Keeping students in school, graduating from high school and receiving post-secondary education is the ticket to earning a livable wage, she said.

“With the press conference today the Kansas Senate is in a position to pass a Medicaid expansion bill quickly,” Sen. Pettey stated Thursday. “This is a bill that 22 senators have already signed onto. A perfect example of bi- partisan negotiations. The governor told us last year it was her No. 1 objective and she is doing everything it takes to have a good bill that will be operational in January 2021. I am honored to be a part of this work.”

State Sen. Kevin Braun, R-5th Dist., on Wednesday night said his priority for care goes to take care of the most vulnerable. He would be willing to look at a separate package for taking care of the indigent, he added.

“I believe in increasing the funding for indigent care in the state of Kansas,” he said. He doesn’t believe that a person on the street who doesn’t have health care insurance is going to carry around an insurance card or paperwork, he said. “I believe they need direct care,” he said.

Sen. Braun said he is willing to increase the funding for indigent care, and to make sure that the disabled are not put in back of a healthy able-bodied person who may or may not want to work.

With 3.5 percent unemployment, he said he would like to look at helping employers provide health care, so that people have the dignity of working and have health care through work, rather than the general public paying for it.

When a similar Medicaid expansion bill passed last year in the House, it was led by Rep. Kathy Wolfe Moore, D-36th Dist., who has been working on the issue for six years.

Currently, Rep. Wolfe Moore said on Wednesday night, about 60 per cent of the clients of the community mental health center here walk in the door without a way to pay for the services.

With Medicaid expansion, they will be able to take care of more people’s health needs, with 90 percent funded by the federal government, she said on Wednesday.

Rep. Wolfe Moore, who served on the governor’s council, said what was really amazing about the compromise agreement on Thursday was the way the Democrats and Republicans could find common ground on an issue so important to the state. Rep. Wolfe Moore said the compromise probably represents the best parts of the House version from last year and the best parts of Sen. Denning’s proposed bill. The compromise bill still has to go through the Senate and House, and then the governor would have to sign it, before it becomes official.

If the bill passes the Senate this year, it would most likely go to a conference committee that would work out differences between the versions, the compromise would be voted upon by both houses, and if approved, go to the governor.

Mike Smallwood, representing the Kansas City, Kansas, Area Chamber of Commerce on Wednesday night, said that the chamber was supporting Medicaid expansion. Also supporting Medicaid expansion were Sister Therese Bangert, who spoke at the Wednesday town hall meeting, and Diosselyn Tot, who spoke on behalf of El Centro. The Unified Government previously announced its support of Medicaid expansion.

In a news release, Gov. Kelly stated that the agreement with Sen. Jim Denning, Senate majority leader, included elements of her plan, of the 2019 House plan and of the bipartisan plan that passed both chambers in 2017.

The agreement stated that there would be full Medicaid expansion to 138 percent of the federal poverty level with a 90-10 federal-state match, effective by Jan. 1, 2021; reinsurance program effective Jan. 1, 2022, pending approval by the Centers for Medicare and Medicaid Services; an actuarial study of the reinsurance proposal by the Kansas Insurance Department; an annual hospital Medicaid expansion support surcharge of up to $35 million effective July 1, 2021, which does not require a tax increase; and a work referral program for non-working Medicaid beneficiaries, promoting self-reliance.

Those who are enrolled for Medicaid expansion would have a monthly premium of up to $25 per month, or $100 for a family of four, according to the compromise agreement. There is a hardship provision in the bill.

In addition, there would be a new advisory committee in the Kansas Department of Health and Environment to support rural hospitals in assessing viability and identifying new delivery models, partnerships and implementing financial reform.

In a news release. Sen. Denning stated that his top priority is to lower the cost of health care for Kansans across the board, to give as many Kansans health care coverage as possible, in the Medicaid and non-Medicaid market.

Both Sen. Denning and Gov. Kelly stated in the news release they would work with their respective caucuses in the coming days to get their feedback and support.

Gov. Kelly stated it was an important first step, but the work is not over yet. She said in the news release that she was calling on them to “bring this over the finish line” in the early days of the 2020 session.

After the governor’s announcement today, the Kansas Hospital Association and the University of Kansas Health System sent out statements in support of Medicaid expansion.

“This agreement is clearly the most significant progress we have seen in the Medicaid expansion debate in Kansas,” Tom Bell, Kansas Hospitals Association president and CEO, said in a news release. “The fact that Gov. Kelly and Sen. Denning have agreed in principle on a plan is momentous. It represents real compromise and is undoubtedly the best, and maybe the only, way to get this through the legislature.”

From the University of Kansas Health System’s statement from president and CEO Bob Page: “We appreciate the hard work and commitment by Governor Kelly, Senator Denning and the legislature to find a workable solution for everyone involved. Now, more Kansans can see a clearer path to meeting their health care needs. With expanded Medicaid coverage and less uncompensated care, hospitals and clinics throughout the state will be able to focus critical resources on evolving patient needs.

“As communities change, we must continue to reimagine how quality healthcare can be delivered most effectively across our state. Expanded health care coverage is one part of a broader solution. We look forward to continuing to work with partners across the state of Kansas to chart a new path forward for healthier, sustainable communities.”

U.S. Rep. Sharice Davids, D-3rd Dist., also issued a statement in support of the bipartisan agreement for Medicaid expansion.

“This is big news for Kansas. Medicaid expansion means over 100,000 Kansans will receive quality, affordable health coverage that protects people with pre-existing conditions. I want to thank Governor Kelly and Senate Majority Leader Jim Denning for coming to the table and reaching a bipartisan deal to help ensure Kansans have access to the health care they need,” Rep. Davids said in a statement.

“I’ve been a vocal advocate for Medicaid expansion, which is why I co-sponsored legislation to incentivize states like Kansas to expand Medicaid by starting the amount the federal government matches state’s investment for expansion at 100 percent. Too many Kansans are struggling with the rising cost of health care, and I’ll keep working to ensure Congress helps states expand Medicaid so we can lower costs and increase access to quality health coverage,” Rep. Davids stated.

The Incentivizing Medicaid Expansion Act, H.R. 584, would allow states to receive 100 percent Federal Medical Assistance Percentages (FMAP) for the first three years after it expands Medicaid, 95 percent for the fourth year, 94 percent for the fifth year, 93 percent for the sixth year, and 90 percent all years thereafter, helping to ease a state’s transition into expansion, according to Rep. Davids.

Under current law, the federal government provides 90 percent FMAP for states newly expanding Medicaid, instead of the 100 percent FMAP for three years proposed in the Incentivizing Medicaid Expansion Act. This bill can be viewed at https://veasey.house.gov/sites/veasey.house.gov/files/Medicaid%20Expansion%20Bill.pdf .