TOPEKA, Kan. (AP) A poison pill in Democratic Gov. Laura Kellys plan for expanding Medicaid aimed at reassuring wary Republican legislators wouldnt actually end the expansion if the federal government backed off its promises to cover most of the cost.
Kelly has said her proposal is based on an expansion plan that passed in 2017 with large, bipartisan legislative majorities, only to be vetoed by Kansas then-conservative GOP Gov. Sam Brownback. But the new Democratic governors working group of Medicaid advisers suggested a key, one-word change when it comes what would happen if the federal government backed off its commitment to cover 90 percent of the expansion.
The 2017 bill said the state shall end expanded Medicaid health coverage for tens of thousands of Kansas residents if the federal government drops its funding percentage. Kellys proposal says the state may end expansion meaning she or a future governor could opt to continue with less federal money.
Documents obtained by The Associated Press through an open records request show that an initial draft of Kellys proposed legislation contained the 2017 poison pill. Kellys advisers on Medicaid expansion suggested the weaker language and it changed before Kelly released her proposal to the GOP-controlled Legislature.
The working group wanted to provide the state with some flexibility in managing the new Medicaid program, while also protecting the states finances should federal funding be reduced, Kelly spokeswoman Ashley All said Monday.
Its not clear how many legislators are aware of the change. Top Republicans remain adamantly opposed to Medicaid expansion, viewing it as costly to the state despite the promised federal funding, and no committee has had a hearing on Kellys specific proposal.
House Majority Leader Dan Hawkins, a conservative Wichita Republican, said if the federal government backed off its funding promises, screaming and the gnashing of teeth over ending an entitlement program would prevent state officials from doing it.
The only way it can be shut down is if its forced by law, he said.
Kansas is one of only 14 states that have not expanded their Medicaid programs or had voters approve a ballot initiative. Supporters argue that expansion would cover thousands of struggling families and boost troubled rural hospitals.
The 2010 federal Affordable Care Act encouraged states to expand Medicaid by offering to cover almost all of the cost.
With conservatives questioning how long Congress would stand by its promise, given federal budget deficits, Kansas 2017 bill stipulated that if the federal governments share of funding dropped below 90 percent, the state was required to end the expanded coverage within a year. A poison pill has been included in a majority of expansion proposals since 2013.
I think thats going to have to be an element of any bill, said Rep. Russ Jennings, a moderate Lakin Republican who supports expansion. Because of the cost implications.
Emails released to the AP show that members of Kellys team were working on a draft of her bill in December. The Medicaid working group met Jan. 18 in a Statehouse conference room, four days after Kelly took office.
A suggestion to change the poison pill language came from that meeting, according to notes circulated to members by email afterward by a Kelly staffer. The notes did not say who suggested the change, but shall became may.
There were a lot of little tweaks that were done, but that was the only substantive change, at least in my mind, from the 2017 bill, said April Holman, executive director of the pro-expansion Alliance for a Healthy Kansas and a member of Kellys group.
