The Kansas House approved Medicaid expansion by a vote of 69-54 Wednesday night while rejecting amendments designed to strip expansion funding for Planned Parenthood, confirm citizenship through the federal e-verify system and publish monthly data documenting improved health outcomes.

Lawmakers overwhelmingly approved, 90-34, an amendment that will disallow the use of expansion funds to pay for abortions, but rejected an amendment to prevent Medicaid expansion funds going to providers that provide “…family planning services but does not provide comprehensive primary and preventative care services” by a vote of 55-69.   The additional funding for the target of the amendment, Planned Parenthood, is not sitting well with Kansans for Life, one of the state’s most powerful lobbying organizations. KFL doesn’t have a position on Medicaid expansion, but Mary Kay Culp, KFL executive director, warned the organization will notify voters about lawmakers who vote to send Planned Parenthood additional funding through expansion.

“We will work with the Kansas Senate to ensure that language is included to prohibit further taxpayer funding of Planned Parenthood,” Culp said.

Twenty-eight Republicans and all 41 Democrats voted to allow expansion funding to go to Planned Parenthood.

Abortion wasn’t the only issue lawmakers debated in their wide-ranging discussion about expansion.  Rep. Stephen Owens, a Hesston Republican, offered an amendment to require that expansion recipients be in the country legally.

“The issue goes back to who it is that we’re trying to take care of,” Rep. Brenda Landwehr, a Wichita Republican, said. “If it is to deal with a lot of illegals, that’s exactly what we need to say so our citizens understand that.”

Others argued utilizing the federal e-verify system would add costs to Medicaid expansion.

“My thoughts are–it’s going to cost a lot less than insuring someone who is illegally here and can’t work legally in Kansas and is therefore not paying taxes into Kansas,” Owens said.

His amendment failed, 61-63.

An amendment offered by Rep. Kristey Williams to require a public reporting and monitoring system met a similar fate, failing 55-67.  Williams’ amendment was designed to document evidence of improved health outcomes and economic benefits that proponents used to justify their support for expansion, but one legislator said it would cost too much to show taxpayers if the expansion was producing the promised results.

“To add this extra burden onto it adds a lot of extra IT costs,” Rep. Susan Concannon, a Beloit Republican, said.

Williams argued that the state is already spending at least $50 million on expansion.

“If we’re going to do that, shouldn’t we at least know where the money is going?” Williams said. “Let’s make sure we have that information available to the public.”

Expansion proponents used a gut-and-go mechanism that allows them to strip one bill and replace it with another. They gutted the original HB 2066, which would have eliminated some regulations for nurse practitioners; they replaced it with Medicaid expansion. Though the rules committee determined the expansion amendment wasn’t relevant to the topic at hand, or “germane,” a majority of legislators, 55-62, disagreed, overruling the House Rules Chair.

Media, many legislators and special interests expressed outrage when the ’gut-and-go’ tactic was used to pass conservative legislation, but that seems to be forgotten now.  Hutchinson Democrat Jason Probst proposed legislation last year to ban the practice, but he and other ‘gut-and-go’ opponents still voted to expand Medicaid by employing the tactic.

The expansion legislation is expected to provide taxpayer-funded health care to another 130,000 people at an estimated annual cost of $50 million. The federal government pays for 90 percent of expansion costs and the state is only required to kick-in 10 percent; taxpayers, however, will eventually pay the full price because the federal portion comes from expanding the national debt, which must be paid back with interest. The Kansas Senate must still adopt an expansion proposal before it becomes law.

Legislators did approve an amendment that will require recipients to pay $25 per month per individual–up to $100 per family–to utilize the program. They also changed wording to require the state to discontinue the expansion program if the federal match rate decreases.

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