House speaker: Medicaid expansion ‘up to the governor’

KHI News Service

TOPEKA — House Speaker Ray Merrick said it will be up to Gov. Sam Brownback to initiate discussions this year in the Legislature about possible Medicaid expansion.

“That’s the governor’s decision and I’ll wait for him to decide what he’s going to do with it,” Merrick said in a pre-session press conference this afternoon. “He can request it and we can take it up.”

House Speaker Ray Merrick, R-Stilwell.  Photo by Phil Cauthon, KHI

House Speaker Ray Merrick, R-Stilwell. Photo by Phil Cauthon, KHI

Legislators last year passed a proviso stating that the program could not be expanded without “express approval” of the Legislature, so Merrick’s comments indicate the GOP-dominated House is unlikely to give the issue much consideration without a push from the Governor’s Office.

Merrick, a Stilwell Republican, said he didn’t know yet how much interest fellow House members might have for reconsidering a broadening of the program, which currently is funded about 60 percent by the federal government and provides health coverage to about 380,000 poor Kansans, most of whom are disabled or elderly.

“This is a new year,” Merrick said. “I really don’t know” how many of the 125 House members might want to wade into the issue.

Between 58,000 and 85,000 Kansans could gain coverage, according to various estimates, if eligibility restrictions were relaxed in accordance with the federal Affordable Care Act, more commonly referred to as Obamacare. The federal law also calls for the feds to pay 100 percent of the cost of covering those newly eligible for Medicaid as a result of expansion. The federal match would drop to 90 percent after 2016.

Senate President Susan Wagle, a Wichita Republican, said earlier this week that she thought any sort of expansion would be difficult to get passed this year in light of the problems that accompanied the launch of the online insurance marketplace. But she said she thought the issue was worth debate and consideration.

She said she was interested in studying something like a plan proposed by Pennsylvania Gov. Tom Corbett, which would require program enrollees to be seeking work and also limit the number of doctor visits. The Pennsylvania plan, like some others being implemented or considered in Republican-dominated states, would use federal Medicaid dollars to buy enrollees coverage from private health plans.

In the past Brownback has said expansion would be up to the Legislature. But administration officials also recently have said that they continue to study the issue and what other states are doing about it.

Sara Belfry, a spokesperson for the governor, said this today when asked for comment on Medicaid expansion:

“Obamacare is fundamentally flawed and the disastrous rollout is just another indicator of the problems we will continue to see,” she said. “Gov. Brownback’s first priority is to extend KanCare (the state’s name for Medicaid) to those who need it most: Kansans with disabilities on waiting lists for services.”

The Kansas Hospital Association and a coalition of more than 50 social service and consumer advocacy groups are pushing policymakers to open up the Medicaid program to more people. Under the Affordable Care Act, hospitals stand to lose money they currently receive for treating the uninsured and without state approval of Medicaid expansion will not be able to offset those losses with additional Medicaid income.