GOP right looks to put own mark on Kansas Medicaid expansion

An Idaho university has started accepting Medicaid as health insurance again meeting its...
An Idaho university has started accepting Medicaid as health insurance again meeting its coverage requirement and reversing a heavily criticized decision. (Source: Medicaid)(KMVT)
Published: Jan. 22, 2020 at 10:13 AM CST
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Conservative Republican lawmakers are looking to modify a bipartisan plan for expanding Medicaid in Kansas by adding two provisions that Democratic Gov. Laura Kelly opposes.

GOP conservatives want to insert a work requirement for able-bodied adults who receive the state's Medicaid health coverage under the expanded program. They're also looking to add a "right of conscience" provision that would allow medical personnel to decline for religious reasons to provide services such as abortion, birth control and gender reassignment care.

The Senate Public Health and Welfare Committee will consider those ideas when it debates a bill containing the bipartisan Medicaid expansion plan, Chairman Gene Suellentrop said Tuesday. The measure arises from a compromise Kelly reached earlier this month with Senate Majority Leader Jim Denning, an Overland Park Republican.

"We're just expressing concerns and using amendments to address some of those issues," said Suellentrop, a Wichita Republican.

The Senate health committee plans to begin hearings on the bipartisan plan Thursday and could debate the bill Feb. 4.

The deal gives Kelly the straightforward expansion of state health coverage that she has advocated to cover as many as 150,000 additional people. Denning would receive a modified version of his proposal to create a new program designed to hold down private health insurance premiums to make it less likely that people would drop their existing private plans in favor of Medicaid.

Denning was among a handful of conservative GOP leaders in the Republican-controlled Legislature who last year kept an expansion plan favored by Kelly from passing the Senate. They cited how a plan would be administered and its potential expense to the state, despite the federal government’s promise to pay 90% of the costs.

The deal appeared to clear the way for Kansas to become the 37th state to expand Medicaid. The bill is sponsored by 22 of the Senate’s 40 members, enough to pass it there, but Sullentrop is not one of them, and his oversight of work on the bill in committee could complicate efforts to get a “clean” bill through the Legislature.

Supporters worry that if conservatives are successful, Kelly will be forced either to accept provisions she believes would hamstring expansion or veto a bill.

Critics of the “conscience” provision see it as allowing anti-LGBTQ discrimination in health care. On her second day in office last year, Kelly issued an order banning such bias in state hiring and employment decisions.

“Patients come in with complex issues, life circumstances, and so its really incumbent on those physicians to help patients navigate that instead of saying, ‘Well, what you’re wanting doesn’t quite fit my own narrow ideology,’” said Julie Burkhart, CEO of the abortion rights Trust Women Foundation. “I just don’t see how people get good health care that way.”

Kelly also opposes a work requirement for Medicaid participants, seeing it likely only to kick people off of coverage.

“Gov. Kelly opposes any proposal that would increase administrative barriers, limiting access to health care,” Kelly spokeswoman Lauren Fitzgerald said in an email.

Denning said he’d prefer to have conservatives’ proposals debated by the full Senate rather than in committee so “we could vote in a transparent manner.”

The bipartisan plan contains what Kelly and Denning describe as a “robust” work referral program for Medicaid participants, to help them find jobs.

“It has a pathway to work, and I prefer that,” said Sen. Ed Berger, a Hutchinson Republican and one of the bill’s sponsor, saying a tougher provision only would be “denying them services.”

But for conservatives a work referral program isn’t strong enough to encourage Medicaid participants become self-sufficient by looking for work or participating in job training. The state imposed work requirements for its cash and food assistance programs during former Republican Gov. Sam Brownback’s tenure with strong backing from GOP lawmakers.

“Work requirements are more broadly popular than Medicaid expansion,” said Sen. Ty Masterson, a Wichita-area Republican who serves on the Senate health committee. “That’s really just a common sense of fairness.”

Masterson also said protecting the conscience rights of medical providers also is “broadly accepted.”

“You shouldn’t be obligated to do something you object to,” he said. “I don’t understand why anybody would back forcing somebody to do a procedure that’s controversial when you have so many other options.”