TOPEKA, Kan. — A Republican-dominated Senate committee has endorsed a plan for expanding government-funded health care for poor and working-class Kansans, despite concerns that it raises tobacco taxes and doesn't have a work requirement for participants.
The Medicaid expansion proposal written by Kansas Senate Majority Leader Jim Denning differs significantly from an expansion plan backed by Gov. Laura Kelly and fellow Democrats.
Denning's plan is designed not only to expand the state's $3.8 billion-a-year Medicaid program but also to lower premiums paid by Kansas consumers who buy their insurance through an online federal marketplace set up under the 2010 federal Affordable Care Act. The goal is to keep some Kansans in private health plans, rather than having them move to Medicaid, as plans favored by Democrats would do.
The Topeka Capital-Journal reports the plan would offer health care coverage to an estimated 150,000 Kansans. It would raise tobacco and vaping taxes by $50 million and add a $31 million surcharge on hospitals and $63 million in fees for managed-care organizations serving Medicaid clients.
Denning, a Kansas City-area Republican, said tax and fee hikes are necessary to pay for expansion.
"We can't put any more stress on the state general fund," he said.
Denning and other top Republican senators blocked a Medicaid expansion plan favored by Kelly earlier this year, arguing that it could prove too costly to the state and that lawmakers needed to take more time to get the details right. Kelly made expanding Medicaid a key promise in her successful campaign for governor last year. At the end of the legislative session Republican leaders vowed to work on a plan to consider in 2020. Kelly also has a panel studying the question.
Medicaid covers about 342,000 low-income, elderly and disabled Kansas residents. Non-disabled adults without children don't qualify, and adults with children must have incomes well below the poverty level to be eligible.
Thirty-six states and the District of Columbia have expanded Medicaid. Kansas is among 14 states that declined, largely because Republican leaders said it would end up costing the state despite a federal government promise to pay for most of the cost.
Democrats this week criticized Denning's GOP plan as unnecessarily complicated.
"We need a Medicaid expansion plan that is simple, effective and sustainable for Kansas," Kelly said in a statement. "We don't need to create extra bureaucratic red tape, raise taxes, and create more hurdles to access to health care."
Conservative Republican senators on the committee questioned lack of a specific provision in the bill prohibiting abortions to be paid by Medicaid, while others were concerned about insurance cost shifts from individuals to the commercial sector.
Under Denning's plan, the state would ask Medicaid participants whether they are employed and, if they are not, what issues keep them from working, so the state can address them. But it's not a requirement that Medicaid participants be employed or undergo job training. Some Republicans see a work requirement as crucial.