Marking a major step towards resolving a longstanding disagreement over the future of healthcare in Kansas, Democratic Gov. Laura Kelly and Senate Majority Leader Jim Denning (R-Overland Park) announced a bipartisan compromise plan Thursday to expand Medicaid in the state.
“This process is far from over, as there are still several critical steps to be taken by the Kansas Legislature," Kelly said in a press release. “But today, Senator Denning and I are proud to stand together to propose a bipartisan compromise that will expand Medicaid and lower healthcare costs for Kansas families. This proposal includes elements of my plan, of Senator Denning’s plan, of the 2019 House plan, and of the bipartisan plan that passed both chambers in 2017.”
“My top priority is to lower the cost of healthcare for Kansans across the board. We want to give as many Kansans health care coverage as we can, in the Medicaid market and the non-Medicaid market,” Denning said, according to the release from Kelly’s office.
“We’ll both be working with our respective caucuses in the coming days to get their feedback and buy-in,” Denning added. “But all sides can find something in this bill to like. That means it’s probably about as middle of the road as it can get.”
The proposal includes expanding the state’s Medicaid program, known as KanCare, to 138 percent of the Federal Poverty Level with a 90/10 match, to take effect no later than the beginning of 2021, and a reinsurance program to take effect the following year, according to the release.
It also includes a Kansas Hospital Association-endorsed annual hospital Medicaid expansion support surcharge of up to $35 million, to take effect by mid-2021, but will not require a tax increase, the release said.
The proposal also “creates an advisory committee within the Kansas Department of Health and Environment to support rural hospitals in assessing viability and identifying new delivery models, strategic partnerships and implementing financial and delivery system reform to improve the health of rural communities,” according to the release.
The plan “includes a robust work referral program that promotes self-reliance for non-working Medicaid beneficiaries, while limiting costly administrative red tape that drives up overall costs to taxpayers,” the release notes. “Enrollees within the expansion population will make a modest contribution for health services through monthly premiums of up to $25 per month, or $100 for a family of four [...]. The bill does not contain any lockouts. Instead, it collects unpaid premiums through the state’s debt setoff program. A hardship provision is also included.”
Rep. Monica Murnan (D-Pittsburg) — a member of the Governor’s Council on Medicaid Expansion — said in an email that she is “very pleased with the compromise that has been reached on Medicaid Expansion.”
The various components of the proposal “are sound and make a clear path for Expansion,” she added. “The reinsurance component is a worthwhile endeavor and could lead to positive impact for even more citizens of the state.
“The fact that over 20 Senators have already supported this bill, shows is it truly a compromise and can move forward quickly, allowing time for other important discussions about rebuilding our state. I really appreciate the Governor and Senator Denning sitting down to work this out.”
Not all area legislators are convinced the compromise proposal is a good idea, however.
"As in the past I have had reservations about expanding Medicaid and that hasn't changed," Rep. Ken Collins (R-Mulberry) said in an email. "I have spoken to several physicians about the expansion and it is a mixed bag with some supporting it while others do not. I have concerns that not all medical professionals accept Medicaid patients and this proposed bill will increase the patient pool while the number of Medicaid accepting doctors will stay the same. I'm also skeptical of the 'poison pill' to the 90/10 federal/state funding that would end the expansion if the Federal government decreases their portion."
Collins added that he is "a supporter of association plans like the Kansas Farm Bureau health coverage that we passed last session. Plans like these can be beneficial to many families in the state."
Sen. Richard Hilderbrand (R-Galena) could not be reached for comment by press time Thursday.
Individuals and organizations who did comment on the compromise proposal announcement Thursday, however, also included Ascension Via Christi.
"Ascension Via Christi extends our appreciation to Gov. Laura Kelly and Sen. Jim Denning for reaching an agreement on expanding Medicaid in Kansas,” the healthcare provider said in a press release. “Ascension Via Christi, along with the Kansas Hospital Association and many other healthcare organizations, have been advocating for Medicaid expansion for the past eight years as a way to make sure that all of our citizens have access to care.”
The release additionally noted that Medicaid expansion “will bring hundreds of millions in federal dollars to our state, giving Kansans residents increased access to health care coverage while supporting healthcare providers and our entire Kansas economy.”
April Holman, executive director of the KanCare expansion advocacy group Alliance for a Healthy Kansas, also reacted to Thursday’s announcement.
“We are grateful to Gov. Kelly and Sen. Denning for taking this momentous step forward for Kansas,” Holman said in a statement. “Reaching this moment is the result of years of tireless work by advocates, health care providers, business leaders and lawmakers to increase access to quality health care. While this proposal includes some elements that may affect affordability, it is a strong plan for closing the health care coverage gap that can gain support on both sides of the aisle. We are hopeful that legislators will come together and quickly advance the best bill possible for our state.”
This article has been updated to include comments from Rep. Ken Collins (R-Mulberry).