Hawver: Medicaid Expansion, School Funding, Taxes and Budget

It took quite a while, but we’re finally getting to the part of the session where most of the boys would be advised to wear protective cups as debate sharpens over school funding, taxes, the budget…and Medicaid expansion.

Martin Hawver, Columnist
Martin Hawver

Things heated up last week when the Senate passed to the House what is the governor’s proposal to appropriate $92 million to the State Department of Education that the governor and (at least publicly) the Senate believes will meet the Kansas Supreme Court order to adequately finance K-12 schools.

The Statehouse grew hotter when the Senate bought some minor House amendments to its major corporate/individual income tax cut bill and sent it to the governor for a (bet on it) veto.

And the session flashed when both the House and Senate (the Senate more artfully) reached into their separate “Mega” bills–the major appropriation legislation of the session–to take the $14 million Gov. Laura Kelly proposed to expand Medicaid (we call it KanCare in Kansas) health care to more than 100,000 mostly poor Kansans.

That flashpoint on Medicaid expansion is probably the most insider politically interesting.  Kelly put in her budget that $14 million, the state’s first-year price tag of Medicaid expansion, that will create a system in which the state will pay 10 percent of health-care costs for poor Kansans and the federal government will pay 90 percent of those bills.

The Legislature passed Medicaid expansion in 2017, saw former Gov. Sam Brownback veto the bill, and was unable to override that veto. But the numbers were big, back then. The Senate mustered 25 votes for the measure, the House 81.  But 81 votes weren’t enough to override the veto.

This year, it appears that the Senate and House might have votes to expand Medicaid and don’t have to worry about a veto. Getting that expansion bill to the floor for debate is the problem.

So, with conservative leadership in both chambers opposed to Medicaid expansion…what happens to that $14 million that Kelly put in her budget…that $14 million that will draw more than $500 million in federal money for health care for Kansas’ poor?

The House Appropriations Committee just took that money that Kelly proposed for starting the program and tossed it back into the all-purpose State General Fund.  Nope, there’s no policy bill on the horizon that would expand Medicaid, but at least that $14 million would have allowed Kansas to operate the program if it found its way to the governor’s desk.

The Senate? It’s Ways and Means Committee was a little more politically clever. A majority of that panel doesn’t want Medicaid expansion but chose to take that $14 million the governor wants and keep it within the Department of Health and Environment…for a different purpose.

Now, Health and Environment isn’t exactly a cuddly agency, but the Senate committee took that $14 million and appropriated it for an increase in the fees it will pay physicians for care of the poor. Two years ago, the Legislature cut doctors’ KanCare payments by four percent. Restoring that four percent costs about $14 million.

So, the Senate can say it favors health care for the poor, just not a whole lot more of them, as some doctors are now refusing to care for Medicaid clients because of low reimbursement. The Senate panel is voting to pay doctors more to keep them in the Medicaid system, which sounds relatively socially progressive, doesn’t it?

Of course, none of that $14 million juggling matters if Medicaid isn’t expanded. And that’s one reason to watch the budget bill—which can’t be amended to include Medicaid expansion–to see whether that $14 million sliver pops the budget…

 

By Martin Hawver

Syndicated by Hawver News Company LLC of Topeka; Martin Hawver is publisher of Hawver’s Capitol Report—to learn more about this nonpartisan statewide political news service, visit the website at www.hawvernews.com

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