State Of Kansas Insurance Commission – Kansas is one of a dozen states that have not yet implemented the ACA’s Medicaid expansion by 2022. As a result, the state has about 45,000 low-income residents stuck in the “coverage gap,” meaning they earn too little to get subsidized private health coverage but are also ineligible for Medicaid because the state refused to accept the feds. Funding for Medicaid expansion.
Attempts to expand Medicaid failed repeatedly in Kansas. Legislation to expand Medicaid was passed in 2017, but then Gov. Sam Brownback vetoed it. Legislation to expand Medicaid was passed again in the Kansas House in 2019, but died in the Senate. Consumer advocates had hoped that the expansion legislation would be passed and signed into law in 2020 — with effective coverage in 2021 — but that didn’t happen. And legislation introduced in the Kansas House in 2022 did not pass committee.
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Although Kansas did not implement the ACA’s Medicaid expansion, the state did implement the American Rescue Plan provision that allows states to extend Medicaid coverage for 12 months after birth (postpartum Medicaid coverage beyond 60 days after the birth of the child). In Kansas, the postpartum Medicaid coverage extension went into effect in April 2022.
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In February 2022, Kansas Governor Laura Kelly, who is supporting Medicaid expansion, announced new legislation (H.B.2675) to expand Medicaid. The bill called for a full expansion of Medicaid as defined under the ACA, along with a system that would direct non-disabled Medicaid applicants to the Kansas Works job search program. But the legislation failed to pass the Kansas House Health and Human Services Committee.
Although Kansas was considered a state to take care of Medicaid expansion legislation in 2020, the bill ultimately failed.
Two bills have been presented for consideration in the 2020 session. S.B.246 was first introduced in early December 2019. It included monthly fees, which could be as high as $25 per enrollee, and would refer unemployed Medicaid expansion recipients to a job training program. And S.B.252, previously introduced in January, was heralded as a bipartisan compromise by Democratic Gov. Laura Kelly and Republican Senate Majority Leader Jim Denning just before the start of the legislative session, raising hopes that Kansas would be the next state. . to expand Medicaid.
The legislation had support from Kansas Democrats, but despite being a bipartisan bill, some state GOP lawmakers publicly opposed it, particularly because it lacked a work requirement. Governor Kelly’s press release on the legislation notes that it includes a “work referral program that promotes self-reliance for Medicaid beneficiaries who are not working,” while limiting the overall cost to taxpayers of costly administrative red tape.
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This is a nod to the fact that Medicaid work requirements are expensive and complicated for states to administer, and almost certain to be challenged in court. By not including a work requirement, the Kansas legislation could cover more low-income residents and make it more difficult for the state to administer.
(While debate over the 2020 legislation was taking place in Kansas during the Trump administration, it should be noted that since the Biden administration took office, HHS has repealed approved work requirements for other states. The COVID pandemic did the same to Medicaid. Work requirements have not started, states (because they can’t take someone off Medicaid during a COVID public health emergency.)
But then-Senate Speaker Susan Wagle (R, Wichita) was opposed to the Medicaid expansion, and refused to let it come up for a vote in the Senate unless both chambers of the legislature approved it. Constitutional amendment that overturned Kansas. the supreme Court ruling protects a woman’s access to an abortion in Kansas.
At that time, access to abortion was still legally protected nationwide under Row v. Wade, but abortion opponents hoped the Supreme Court would overturn it at the federal level (which happened in 2022). The Kansas ruling upholds a woman’s right to choose in Kansas, regardless of federal rules. But Wagle and other anti-choice Republicans in Kansas would like to see that change, and have blocked 2020 Medicaid expansion legislation to try to pass an abortion amendment.
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Senate Democrats made a last-ditch attempt to pass a Medicaid expansion measure in May, but failed due to procedural rules. Denning said he was “very disappointed” the bill never received a debate in the 2020 session.
The bill’s latest defeat came after the COVID-19 pandemic was well underway, with millions of Americans losing their jobs and health insurance to the virus. Medicare expansion is a vital safety net for people who lose income and health coverage, but it’s not available in Kansas and 11 other states.
Senator Barbara Bollier, M.D. A co-sponsor of two Medicaid expansion bills, he wrote an article on our website in 2017 about the importance of Medicaid expansion and his tireless efforts to convince other Kansas lawmakers to expand coverage. Bollier was a Republican at the time, but became a Democrat in 2018 and ran unsuccessfully for the 2020 United States Senate. Wagle was running for the Republican nomination to run against Bollier, but dropped out in May 2020.
A summary of the bipartisan Medicaid expansion legislation (S.B.252) is available here. In summary, here is what was proposed, although the legislation ultimately did not succeed:
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H.B.2066, which called for Medicaid expansion, passed the Kansas House in March 2019 by a vote of 69-54 (note that the bill has been revised; it originally addressed nursing regulations, but that text was replaced by the Medicaid expansion text in the final version). But it never got a vote in the Senate, as Rep. Brett Parker of Kansas explained here.
Similar to legislation introduced in 2020, H.B.2066 included a job training referral program and monthly payments of up to $25 for Medicaid expansion enrollees.
In September 2016, Sandy Praeger, a Republican and former Kansas insurance commissioner, urged Governor Brownback and Kansas lawmakers to expand Medicaid, saying there was “no logical explanation.” The decision was based on politics rather than cost analysis.
And the state’s August 2016 primary election pushed several moderate Republicans onto the November ballot, energizing Medicaid expansion advocates. Supporters were more confident than ever that they could pass a coverage-expansion bill in 2017, especially given that many of the top winners had talked about helping to expand coverage. -Medicaid.
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On February 23, 2017, H.B.2044 passed the Kansas House of Representatives 81-44. A month later, the bill passed the Senate, 25-14. But then-Governor Sam Brownback remained steadfast in his opposition to Medicaid expansion, vetoing the bill. Although the Medicaid expansion legislation passed by wide margins in both chambers, it fell just a few votes short of a veto-proof majority.
On April 3, the House voted to accept Brownback’s veto. The final margin was 81-44, three votes short of the 84 votes needed to override the Governor’s veto. Two delegates who voted for the expansion ended up voting to uphold the veto, while two others who opposed the expansion switched sides and voted to override the veto. In the end, the numbers remained the same as last week, and the governor’s veto remained in effect.
In 2014, Brownback signed legislation (H.B.2552) that would require legislative approval to expand Medicaid (instead of authorizing it through executive action, which is the way governors in some states have used to expand Medicaid without getting legislative approval). ). H.B.2552 was popular among Brownback and conservative lawmakers in 2014, especially because of the stronger-than-expected gubernatorial campaign of then-House Minority Leader Paul Davis — a Democrat who supported Medicaid expansion.
The American Cancer Society, which supports Medicaid expansion, reported that 82 percent of Kansas respondents wanted the state to accept federal funding for Medicaid expansion. Hospital leaders in Kansas also pushed hard for Medicaid expansion, noting that without the expansion, some rural hospitals would be forced to close. Although the measure passed by wide margins in both houses, it was not enough to override the governor’s veto.
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Lawmakers revisited Medicaid expansion in the 2018 legislative session, though the bill did not pass. Jeff Colyer, who took over the Governor’s office in January 2018 when Brownback left to join the Trump Administration, was opposed to expanding Medicaid in the state and is likely to “vote against an expansion bill,” as Brownback did.
The Senate Public Health and Welfare Committee approved the 2018 Medicaid expansion bill (S.B.38) in February, but did not move forward. House Democrats also tried to amend other 2018 bills, including the budget bill, to include Medicaid expansion, but were unsuccessful.
The KanCare 2.0 waiver proposal originally called for a work requirement and a 36-month cap on Medicaid benefits. CMS rejected the 36-month limit and Kansas removed the work requirement