(April 5, 2019) – Despite the continuing lack of action on KanCare expansion this session, there was quite a bit of activity surrounding the issue this past week.
One of the more interesting happenings occurred when protesters displayed massive banners in the Capitol rotunda castigating House and Senate leaders for not expanding KanCare. The banners, which in my opinion were in poor taste, were quickly pulled down by Statehouse employees. The response from some of the legislative leaders, however, was interesting. House Speaker Ron Ryckman (R-Olathe), one of those criticized, said the method of communication wasn't particularly alarming because "it's people's free right to expression." Rep. Dan Hawkins (R-Wichita), the House majority leader, said that "supporters of socialist health care don't care about the facts."
Gov. Laura Kelly's activity level also increased, as she held a press conference earlier this week to encourage Senate leadership to take action on KanCare expansion before the Legislature's April recess begins. Gov. Kelly stressed the 2019 expansion bill, which was passed by the House last month, is very similar to the legislation that passed in both chambers in 2017. Senate President Susan Wagle's (R-Wichita) response echoed a familiar theme when she said "The governor just called for the Senate to pass a bill that Bernie Sanders – a socialist – endorsed. And that's not going to happen in the Kansas Senate."
This week, Sen. Wagle and some other Senate leaders did offer up a proposal of sorts: have an interim study of expansion later this year and take up a bill in 2020. Wagle said legislators need months to review what other states have done, study what limits the Trump administration might allow and add some “caveats” to the legislation.
All this activity may provide for good political theater, but it doesn't do anything to move the issue forward. It may feel good to call expansion supporters socialists, but it does nothing to further the process. By the way, does that term apply to former Indiana Gov. Mike Pence because he expanded Medicaid in Indiana?
Sen. Wagle's interim study proposal would have made sense five years ago when these discussions began. The few states that expanded Medicaid as soon as the law allowed were just starting out, and it was unclear what types of alternative policies would be allowed by the Centers for Medicare & Medicaid Services. But now, five years later, 36 states and the District of Columbia have expanded Medicaid. We know which program components have been approved, which have been rejected, and which have been implemented successfully. We also have learned from other states how best to estimate the utilization of the program and what likely will be the costs and cost savings.
Here's the bottom line: We've heard "Let's wait until next year" too many times. In the five years since Medicaid expansion went into effect under the Affordable Care Act, the Kansas Legislature has held numerous hearings on expansion, received hundreds of pieces of testimony, and engaged in hours of round-table discussions. In addition, many organizations across the state have held forums engaging experts from all over the country in discussing the impacts and options for expansion. And while we were doing all of that, 36 other states expanded their programs.
It's time for Kansas to act.