Kansas House panel, hospitals pushing for expansion of Medicaid despite strong GOP opposition

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TOPEKA, Kansas — Hospital officials gave their backing Monday to a Kansas House committee's effort to expand the state Medicaid program to capture additional dollars under the federal health care overhaul, despite opposition to the plan from Republican leaders.

The Vision 2020 Committee heard supportive testimony from Tom Bell, president and CEO of the Kansas Hospital Association, and two top executives with Via Christi, the state's largest health system. They said expanding Medicaid as contemplated by the 2010 federal health care law would provide coverage to another 169,000 Kansas residents, including 100,000 with jobs.

Committee Chairman Tom Sloan, a Lawrence Republican, is pursuing the Medicaid expansion plan despite strong opposition from top Republicans in the GOP-dominated Legislature. Sloan is more liberal than most other GOP lawmakers, and his committee — set up to study long-term problems — is unusual in not being controlled by conservatives.

The state's $3 billion-a-year Medicaid program provides health coverage to 368,000 needy and disabled Kansans, but it doesn't cover able-bodied adults without children, and many parents aren't covered unless their incomes fall well below the federal poverty level. Meanwhile, the federal health care law provides insurance subsidies for families but only at or above the poverty level, or $23,850 for a family of four.

Bell said the Hospital Association is working on legislation to authorize Republican Gov. Sam Brownback — a strong opponent of the federal health care law — to negotiate the terms of an expansion with the federal government. Sloan said his committee's bill will be more specific and include provisions for raising any state dollars needed to match federal funds. State law currently prohibits a Medicaid expansion.

"I think the point is, let's have a serious discussion about this," Bell told the committee.

Rep. Jim Ward, a Wichita Democrat, introduced a bill last week to expand the Medicaid program as contemplated by the federal law.

But most Kansas Republicans view that law, championed by Democratic President Barack Obama, as expanding the federal government and creating new burdens for businesses — and don't want any state involvement.

The federal government promises to pay the full cost of a state's Medicaid expansion through 2016 and at least 90 percent after that. But top Kansas Republican legislators are skeptical that the promise will be kept.

"Can you tell me — anybody tell me — it's going to be there forever?" said House Speaker Ray Merrick, a Stilwell Republican. "No."

Senate Majority Leader Terry Bruce, a Nickerson Republican, said GOP lawmakers are reluctant to extend social services benefits to able-bodied adults. He also doubted the state can provide matching funds.

The state faces budget shortfalls totaling more than $710 million in its current budget and the one for the fiscal year beginning July 1. The gaps arose after lawmakers aggressively cut personal income taxes in 2012 and 2013 at Brownback's urging to stimulate the economy.

Bell said hospitals are even willing to consider a special tax to raise the state's matching funds, believing it's worth it to get the additional federal dollars. Also, the group contends expanded coverage will decrease other costs, such as those hospitals incur when indigent patients use emergency rooms for their primary medical care.


Online:

Kansas Hospital Association: http://www.kha-net.org/

Kansas Legislature: http://www.kslegislature.org


Follow John Hanna on Twitter at https://twitter.com/apjdhanna .

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