Medicaid expansion will probably fail again in Kansas, so why is the governor still trying?

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Gov. Laura Kelly’s likely doomed push for Medicaid expansion is aimed at setting the table before this fall’s election. But Republican leaders want to focus on other ideas, like cutting taxes.

TOPEKA — With the Kansas legislative session underway, Democratic Gov. Laura Kelly is again calling for lawmakers to expand Medicaid to provide health care to about 150,000 low-income Kansans.

That’s despite knowing that the Republican-controlled Legislature is going to reject the proposal, even with Kelly’s pitch to add work requirements to the federal program.

But Kelly isn’t shy about the larger strategy behind her latest attempt. She’s using the 2024 election, where every seat in the Kansas Legislature will be up for vote, as a high-profile backdrop. She hopes her campaign for Medicaid expansion will influence lawmakers to finally pull the trigger — or risk losing their seats in the fall.

“They need to be responsive to their constituents,” Kelly said in an interview. “And I think they will feel that pressure. I’m hoping they’ll turn that pressure into action.”

Republican leaders have different ideas they want to focus on in 2024, including cutting taxes amid a massive budget surplus and expanding school choice options.

And Republican leaders may also try to use the upcoming election to benefit their own agenda. Some of the party’s top priorities are likely to be vetoed by Kelly, requiring an override attempt by lawmakers to enact their conservative agenda.

While some of those attempts failed last year — notably falling just short of enacting a flat-rate income tax that would have cut hundreds of millions from the state budget — Republican leaders and conservative advocacy groups may try to pressure holdouts with the specter of a difficult reelection campaign.

Medicaid

Kansas is now one of only 10 states that has not expanded Medicaid.

Along with providing health care to thousands of Kansans, expanding Medicaid would come with about $700 million of federal funding. That could be important for rural hospitals that are struggling to stay open.

In her latest pitch, Kelly proposed adding work requirements to the program, which Republicans have wanted to add to other state welfare programs.

The attempt to meet Republicans in the middle is not likely to work. Republican leaders have already said it is a non-starter, despite nearly 70% of Kansans saying they support expansion.

Gov. Laura Kelly unveils her new Medicaid expansion proposal during a news conference Thursday, Dec. 14, 2023 at Holton Community Hospital.
Democratic Gov. Laura Kelly unveiled her new Medicaid expansion proposal during a news conference Thursday, Dec. 14, 2023 at Holton Community Hospital. Republican leaders rejected the plan almost immediately. (Sherman Smith / Kansas Reflector)

House Speaker Dan Hawkins also criticized Kelly’s work requirement proposal. He said federal officials would need to sign off on a work-requirement provision for Medicaid and that is very unlikely.

“While I appreciate the Governor’s newly found support for work requirements for welfare benefits,” Hawkins said, “this is nothing more than smoke and mirrors.”

Kelly has taken a more offensive approach by campaigning around the state in recent months to drum up support from voters and build pressure on lawmakers.

“Their opposition is strictly political,” Kelly said. “So we’ve taken a much more political approach to getting it passed.”

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Taxes

Last year, Republican leaders pushed a flat-tax bill that would have set a 5.15% income tax rate for the vast majority of Kansans. That provision would have cut $330 million from the state budget.

But Kelly vetoed that plan, arguing it mostly helped the wealthiest Kansans and would cause budget concerns down the road.

However, the state is on path to have about $2.8 billion in budget surplus next summer. So finding ways to return some of those dollars to Kansans through tax cuts will be a major focus.

Kelly said she too wants to cut taxes. But she will continue to veto plans she believes are not in the best interest of the state and the health of its budget.

Republicans in the Senate fell just one vote short of overriding Kelly’s veto to the flat tax plan. The override attempt never reached the House, but appeared to have support. More than two-thirds of the chamber voted to approve the bill in its initial vote before Kelly vetoed it.

Republican leaders could bring the proposal back this year and try to convince some of the holdouts to abandon their opposition. They may also try to use the upcoming election to their advantage.

Republican Sens. Alicia Straub and Rob Olsen initially voted to support the flat-tax plan, but they both rejected an attempt to have the chamber vote a second time on a veto override. Straub specifically voted to “pass” on the reconsideration.

In response, conservative advocacy group Americans for Prosperity — a major proponent for the tax plan — sent 10,000 mailers to their districts criticizing them for their votes, according to Sunflower State Journal.

Republican House Speaker Dan Hawkins speaks to reporters during a press conference with the many Republican lawmakers.
Republican lawmakers may again pursue a flat income tax bill that Kelly vetoed last year. They may also try to use the upcoming election to pressure holdouts to vote for another veto override attempt. (Blaise Mesa / Kansas News Service)

Straub, who will have Republican Rep. Tory Marie Blew as a primary challenger if she chooses to run again, recently lamented the group’s methods and its influence in Kansas politics in a GOP newsletter.

“AFP likes to control politicians so much,” Straub said in the newsletter, “that if one dare ‘Pass’ on playing childish games with ‘leadership,’ they try to punish and deter others from voting their moral principles.”

Education

Republicans are also likely to try again on expanding school vouchers, which provide tax relief to parents who send their children to private schools.

Last year, the Legislature passed a bill that would give up to $5,000 in tax credits for parents to use for private school or homeschooling. But Kelly vetoed that bill as well.

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Critics argue the idea is meant to push public education dollars to private schools. Kelly also said that there aren’t enough private schools in Kansas, particularly in rural areas, for there to be much benefit.

Still, supporters contend vouchers are a good alternative to public education amid anger and frustration with schools in recent years over COVID-19 restrictions and diversity, equity and inclusion policies.

Hawkins said in Wichita recently that school vouchers are a priority.

“People are tired,” Hawkins said, “of some of the things that are going on in schools.”

Medical marijuana

Recent polling shows many Kansans still want the state to consider legalizing medical marijuana. Kansas is one of only a few states with no legal recreational or medical cannabis access.

Republican Senate President Ty Masterson remains skeptical about medical use of cannabis, and his opposition in the past was a major hurdle. He said legalizing medical marijuana sets the drug on the path to legalizing recreational use, which he opposes despite a majority of Kansans supporting it.

But he said he doesn’t completely oppose medical marijuana. He said recently on KCUR’s Up to Date that it comes down to how the cannabis is administered and what is the right dosage.

“I’m actually open to true medical marijuana or to palliative care,” Masterson said. “I’m not saying no. I’m just saying we don’t have any real studies on dosage and distribution.”

Dylan Lysen reports on social services and criminal justice for the Kansas News Service. You can follow him on Threads @DylanLysen or email him at dlysen (at) kcur (dot) org.

The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.

Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.

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