The Kansas House Appropriations committee stripped $14 million from Gov. Laura Kelly’s proposed budget today. During a tense debate, a narrow majority of the committee, 12-11, voted to remove a placeholder for Medicaid expansion funding from the Kansas Department of Health and Environment portion of the state budget. Its removal will make it more difficult for expansion advocates to advance the legislation in the House this year.
“Hopefully this money stays in, and we can have an honest debate on the floor,” said Rep. Kathy Wolfe Moore, a Democrat from Kansas City, Kansas. “…Leaving it out today is just an effort to run out the clock and make sure (expansion) doesn’t happen.”
Lawmakers and a variety of experts and stakeholders spent three days exploring Medicaid expansion implications during a series of round table discussions last week, but legislative proposals to add an estimated 150,000 able-bodied Kansans to the state’s Medicaid rolls have yet to receive a committee hearing. Expansion advocates blame House leadership for stalling, but Rep. Brenda Landwehr, who oversaw the round table discussions, disagrees.
“What leadership is doing is giving the committee time to actually get into the weeds and the details,” the Wichita Republican said. Landwehr said her goal is to begin next week dissecting what she learned during round table discussions.
Obamacare, also known as the Affordable Care Act, allowed states to increase their Medicaid rolls to include able-bodied adults who met certain income guidelines. Under the program, the states pay 10 percent of expansion cost, and the federal government pays 90 percent. Kansas is one of 14 states that hasn’t expanded its Medicaid program.
“There is not one single state that hit their guesstimate of what it would cost,” Landwehr said. “How is Kansas going to be different?”
The costs projected in Kelly’s budget pose a problem, according to Rep. J.R. Claeys. Kelly budgeted $14 million in state expenditures next year for an expansion program, but a recent Kansas Health Institute study estimates expansion would cost the state nearly $50 million in the first year and nearly half a billion dollars over the next 10 years.
“We should at least be honest with ourselves when it comes to what the real costs are to doing this,” Claeys said.
Kelly’s budget used a fiscal note prepared two years ago, when lawmakers formally debated and passed Medicaid expansion. Then-Gov. Sam Brownback vetoed the proposal, and a veto override fell short in the Kansas House. Kelly has made expansion a centerpiece goal of her administration, but without a funding placeholder in the budget, passing Medicaid expansion poses challenges. The House has a rule known as “pay-go;” if a lawmaker proposes expanding Medicaid as an amendment to the budget during floor debate, they must also offset the cost of expansion by removing money elsewhere in the budget.
Wolfe-Moore called the discussion to strip the placeholder from the budget a “chicken and the egg” scenario.
“We can’t have the debate, because we don’t have the money. We don’t have the money, so we can’t have the debate,” she said.