Jan 09, 2020 4:30 PM

Governor, GOP leader unveil Kansas Medicaid expansion plan

Posted Jan 09, 2020 4:30 PM
Governor Kelly and  Senate Majority Leader Jim Denning take questions during Thursday news conference in Topeka -image courtesy office of Kansas governor
Governor Kelly and  Senate Majority Leader Jim Denning take questions during Thursday news conference in Topeka -image courtesy office of Kansas governor

TOPEKA, Kan. (AP) — Kansas Democratic governor and a top Republican lawmaker on Thursday outlined a new proposal for expanding the state's Medicaid program, breaking an impasse that had allowed a handful of GOP leaders to thwart bipartisan legislative majorities.

The plan from Democratic Gov. Laura Kelly and Senate Majority Leader Jim Denning would give Kelly the straightforward expansion of state health coverage that she has advocated, covering as many as 150,000 additional people. But Denning would get a version of a program that he has proposed for driving down private health insurance premiums to make it less likely people would drop existing private plans for Medicaid.

Denning had proposed financing his new program by increasing tobacco taxes, including a $1-per-pack increase in the state's cigarette tax, to $2.29. His compromise with Kelly gives the state a year to develop the premium-reduction program and drops the tax increase, which Kelly and many lawmakers thought wasn't likely to pass anyway.

The governor's deal with Denning, a Kansas City-area Republican, means an expansion bill is all but certain to pass during the Legislature's annual session, which convenes Monday. Bipartisan majorities in both chambers support expansion.

The House passed an expansion plan last year, but Denning and other GOP leaders were able to keep it bottled up in a Senate committee. They cited concerns about the state's potential costs and how expansion would be administered.

Thirty-six states have expanded Medicaid or had voters approve ballot initiatives. The Kansas Legislature approved a plan in 2017, but then-GOP Gov. Sam Brownback vetoed it. Kelly made expansion a key promise of her successful 2018 campaign, arguing it would help thousands of working families and bolster struggling hospitals, particularly in rural areas.

Legislators have come under increasing pressure from health care advocates and the state hospital association, and conservative Republicans' resistance sparked sporadic Statehouse protests last year.

But top GOP senators had promised to allow a debate on expansion this year. Denning floated his alternative proposal — with a more modest expansion than Kelly wanted — before having weeks of discussions with her.

“I am confident that we will get something done in this legislative session that we will all be able to live with,” she said in an interview with The Associated Press last week.

Denning had political incentives to push for an expansion plan this year. Kelly carried his home county by nearly 19 percentage points in 2018, and President Donald Trump's problems with suburban voters also makes Denning's seat a top Democratic target this year.

Denning's willingness to work with Kelly left even some ardent opponents of expansion anticipating passage after nearly a decade of debate.

“I don't have the votes to stop Medicaid expansion," House Majority Leader Dan Hawkins, a Wichita Republican who strongly opposes it, said amid Kelly and Denning's talks.

Kansas' $3.8 billion-a-year Medicaid program covers more than 341,000 low-income, elderly and disabled Kansas residents. However, non-disabled adults without children don't qualify, and adults with children must have incomes well below the federally set poverty level to be eligible for coverage.

Kelly has said the expansion would cover as many as 150,000 additional people. The nonpartisan, nonprofit Kansas Health Institute has said Medicaid would cover about 130,000 more people but has projected that nearly 55,000 of them would switch from private insurance.

The federal Affordable Care Act of 2010 encouraged expansion by promising states that the federal government would pick up the bulk of the extra cost, 90% for Kansas. Brownback and other Republicans in Kansas were wary of the cost of even the state's 10% share and viewed the federal health overhaul — former Democratic President Barack Obama's signature domestic achievement — as damaging to the economy.

The new expansion proposal would extend Medicaid coverage on Jan. 1, 2021, to Kansas residents earning up to 138% of the federal poverty level, or $29,435 for a family of three.

Denning had proposed an initial expansion at the federal poverty level, $21,330 for a family of three, with the premium-reduction program helping others stay in private health plans. Under the new proposal, the state would commit itself to starting the premium-reduction proposal in 2022.

The new proposal also includes Denning's proposal for a “robust” program to refer Medicaid recipients to services to help them find and train for jobs. Some GOP conservatives want to go further by imposing a work requirement, something Kelly and others consider legally questionable.

The proposal also would allow the state to charge new Medicaid participants a premium of up to $25 per individual and $100 per family. It also would ask hospitals to kick in $35 million a year to cover the state's costs.

Continue Reading St Joseph Post
Jan 09, 2020 4:30 PM
With Pompeo out, GOP can't dodge Kansas Senate race headache
Photo courtesy  Kris Kobach campaign

TOPEKA, Kan. (AP) — Secretary of State Mike Pompeo’s declaration Tuesday that he won’t run for Senate in Kansas returned some Republicans to worrying that they can’t block a polarizing conservative from winning the GOP nomination and putting the seat in play.

Pompeo’s decision to remain as the nation’s top diplomat, assuming he sticks by it, means the GOP can’t dodge the issue that had prompted top Republicans to woo Pompeo for months. They saw Pompeo as the best bet for torpedoing hard-right immigration policy advocate Kris Kobach’s bid for the Senate.

The turmoil in the Middle East that preceded Pompeo’s decision could help Kobach with hawkish GOP primary voters. Kobach, the former Kansas secretary of state, has spent two decades building a national profile partly by framing illegal immigration as a national security issue and touting his work with the U.S. Justice Department right after the 9/11 terror attacks.

Some anti-Kobach Republicans focused quickly on the race’s best-funded candidate so far, GOP Rep. Roger Marshall of western Kansas. But he still faced skepticism about his conservative bona fides and whether he can stop Kobach, particularly absent a one-on-one match.

“Everybody but Kobach probably should get together and say, ‘Now why are we doing this and what are we trying to gain?’ And pick somebody and go head-to-head,” said Tim Shallenburger, a former Kansas Republican Party chairman and state treasurer.

Pompeo’s decision complicates GOP efforts to defend their 53-47 Senate majority in November’s elections. The national party and its allies face the prospect of having to put resources into Kansas, even though Republicans haven’t lost a Senate race there since 1932.

Pompeo has said repeatedly that he’d remain secretary of state as long as President Donald Trump will keep him. But his travels to Kansas last year — and comments from Trump — kept buzz about a potential candidacy alive.

He told reporters Tuesday: “I said the same thing yesterday that I’ve said for months. No.”

Fears that a Kobach nomination could put the seat in play arose even as four-term Republican Sen. Pat Roberts, now 83, announced a year ago that he wouldn’t seek re-election. Kobach lost the Kansas governor’s race in 2018 to Democrat Laura Kelly — a contest many in the GOP thought winnable.

The National Republican Senatorial Committee questioned Kobach’s ability to win a general election when he announced his candidacy last summer.

And Scott Reed, the U.S. Chamber of Commerce’s chief political strategist, who ran Bob Dole’s 1996 presidential campaign, said, “We continue to think Kobach is a loser.”

Some Republicans want to winnow the field by urging candidates at the back of the field to drop out. Kelly Arnold, another former state GOP chairman, said if candidates can’t conduct effective fundraising, “it’s time for them to get out.”

Kobach said Tuesday that his independence bothers the Republican establishment — including U.S. Senate Majority Leader Mitch McConnell — and led it to woo Pompeo. His supporters argue that with Trump on the ballot in November, fears of losing the Kansas seat are misplaced.

“We’re seeing a race where conservatives are lining up behind me,” Kobach said.

Kobach also believes his background is an asset with tensions high in the Middle East. At the Justice Department, he helped develop a system that forced more than 80,000 foreign residents to register with the U.S. government so that it could know why they were there for security reasons. Widely derided by civil rights groups, it was abandoned in 2011 by President Barack Obama’s administration.

Photo courtesy Congressman Dr. Roger Marshall

Marshall spokesman Eric Pahls said the congressman’s seven years in the Army Reserve are more crucial.

“Kansans want to know there’s someone with military experience helping to make these decisions,” he said.

But Bob Beatty, a Washburn University of Topeka political scientist, said Kobach has built a reputation among Republicans as “someone who doesn’t back down.”

“A foreign policy crisis is going to bring out more conservative voters,” Beatty said.

The leading Democratic candidate is state Sen. Barbara Bollier, a retired Kansas City-area anesthesiologist who made national headlines by switching from the GOP at the end of 2018. She has endorsements from Kelly and former U.S. Health and Human Services Secretary Kathleen Sebelius, a former two-term Democratic governor, and she already is pursuing moderate voters.

Bollier’s campaign announced Tuesday that she’s raised more than $1 million over the past three months — a sizable amount in a low-cost media state like Kansas.

But Marshall began his race with a sizeable balance from his House campaign and entered the final three months of 2019 with nearly $1.9 million in cash. That was twice as much as the combined total of his main GOP rivals, Kobach, Kansas Senate President Susan Wagle and Dave Lindstrom, a Kansas City-area businessman and ex-Kansas City Chiefs professional football player.

The U.S. Chamber helped Marshall win his congressional seat in 2016 by defeating tea party firebrand Rep. Tim Huelskamp. Reed said they’re considering helping him in the Senate race and the “onus is on him” to show he can win the nomination.

Marshall launched his first television ad before Christmas, describing himself as a foe to “Trump haters and their phony impeachment.”

Yet Marshall is hasn’t yet convinced some Republicans. Shallenburger sees his pro-Trump statements as “pandering” and says his ouster of Huelskamp has him perceived as a moderate, despite a conservative voting record.

Kobach is better known and, to some conservatives, just more exciting. University of Kansas political scientist Patrick Miller said Kobach excels “at the theater” of politics, while Marshall seems “vanilla.”

“If central casting called for a generic Republican congressman, that could be Roger Marshall, right?” Miller said. “Someone to just, like, be in the background of the movie shot.”