Kansas Senators adopted legislation to expand Medicaid on Tuesday morning, but the measure will likely meet the business end of Gov. Sam Brownback’s veto pen. The lopsided 25-14 vote is not enough to override a potential veto.

Overriding a Brownback veto requires 27 votes in the Senate and 83 votes in the House. The measure fell two votes shy of that, 81-44, in final House passage.

Brownback has consistently voiced his opposition to expanding Medicaid, though he stops short of threatening a veto. Prior to a Senate vote, his communications director Melika Willoughby tweeted a statement from the Governor.

“To expand Obamacare when the program is in a death spiral is not responsible policy,” his statement reads. “Kansas must prioritize the care and service of vulnerable Kansans, addressing their health care needs in a sustainable way, not expanding a failing entitlement program to able-bodied adults.”

The Senate wrestled with expanding Medicaid just as U.S. House leadership shelved a plan to make changes to Obamacare, the program that provides matching funds to states for Medicaid expansion. One proposed change to the federal program would limit how much federal aid states would receive for Medicaid.

Kansas Senate President Susan Wagle said without Congressional action, Obamacare will collapse and states that expand Medicaid will be left holding an expensive entitlement bag. She called the federal government an unreliable partner in Medicaid and called the Kansas legislation, “untimely.”

“I have absolutely no confidence that the Obamacare program will continue as it is,” she said. “I have no confidence that the federal government isn’t going to pass on the costs to the states. This is a partnership with an entity that cannot pay their bills on a program they say is unsustainable.”

Senators debated costs of Medicaid expansion. Senate Majority Leader Jim Denning, an Overland Park Republican, argued expansion will cost the state more than $222,000 per day. The fiscal note attached to the bill includes possible savings, but the anticipated 150,000 new Medicaid recipients won’t pay copays for doctor’s visits or prescriptions. Recipients also aren’t charged a deductible, but Topeka Sen. Vicki Schmidt, a proponent of the proposal, argued cost savings and the federal aid means expansion would be revenue positive for the state.

Sen. Ty Masterson said everyone laughs at that suggestion. Kansas is one of 19 states to resist Medicaid expansion, while 31 states expanded their programs.

“There’s not a single state that’s expanded that’s hit its cost estimates. Not a single one,” the Andover Republican said. “If we really think this thing is going to be $77 million positive, how far do we have to expand it before we no longer need to raise taxes? We laugh, right? Because we all know better…There is no rationally thinking person who thinks this is going to be a huge fiscal boon to this state.”

The Kansas Department of Health and Environment estimates expanding KanCare will cost the state as much as $1.1 billion by 2020, and an independent actuarial study estimated the cost at $1.2 billion through 2025. The Kansas Health Institute, a nonprofit organization, estimates Medicaid expansion would cost the state $729.7 million over the next seven years. KHI research suggests 71,000 people with private insurance will move to Medicaid if the state expands the program.

Masterson said there’s a reason the 19 states that haven’t expanded Medicaid aren’t rushing to do so now. Schmidt, the bill’s primary proponent, said Georgia and Virginia will consider expansion, however.

“We’re standing in line at an amusement park ride that’s broken, closed,” Masterson said.

How They Voted

Yeas: Berger, Billinger, Bollier, Bowers, Doll, Faust-Goudeau, Francisco, Givens, Goddard, Haley, Hardy, Hawk, Hensley, Holland, Kelly, Kerschen, Longbine, McGinn, Pettey, Rogers, V. Schmidt, Skubal, Sykes, Taylor, and Wilborn.

Nos: Alley, Baumgardner, Denning, Estes, Fitzgerald, LaTurner, Lynn, Masterson, Olson, Pilcher-Cook, Pyle, Sullentrop, Tyson, and Wagle.

Absent: Petersen.

Once the bill reaches Brownback’s desk, the Governor has three choices: He can sign it, and it becomes law. He can veto it or he can allow it to become law without his signature.

 

 

 

 

 

 

 

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