TOPEKA — Proponents of Medicaid expansion face an uphill battle in this year's legislative session despite, or perhaps because of, Gov.-elect Laura Kelly's support for the idea.

Democrats worry Republican leadership again will stifle discussion on hot-button health issues, such as Medicaid expansion and medicinal marijuana.

Kelly, a Democrat who made expansion a cornerstone of her campaign, said health care is a critical need that remains inaccessible to many people. By loosening qualifications, an estimated 150,000 Kansans would gain access to health coverage while unlocking federal dollars to cover 90 percent of the cost.

“My administration will work on a bipartisan plan to expand Medicaid so that more Kansans have access to health care, our rural hospitals can stay open, and the tax dollars we send to Washington come back home to Kansas to help our families," Kelly said.

Any bill she signs will have bipartisan support because Republicans control both chambers. House Speaker Ron Ryckman, R-Olathe, said many questions remain unanswered about expansion of Medicaid, which serves disabled, pregnant and low-income Kansans. Proposals would funnel most of the federal dollars to medical facilities in Sedgwick, Johnson and Wyandotte counties, he said.

"We're always open to ideas," Ryckman said. "What we don't want to do is give false hope, especially to a lot of our rural hospitals."

Sen. Ed Berger, a Republican from Hutchinson and vice chairman of the Public Health and Welfare committee, said it was possible Medicaid expansion won't get a hearing at the committee level. He also worried that work requirements for those who participate in the program could be used as a carrot to bring more Republicans to the bargaining table.

“I’m not sure what the end product will look like, but that could very well be a component of it," Berger said.

The Legislature passed an expansion bill two years ago but didn't have enough support to override the veto of former Gov. Sam Brownback. Last year, Democrats frustrated about being stiff-armed on the issue unsuccessfully tried to attach an expansion package to other bills.

Rep. Cindy Holscher, a Democrat from Olathe who sits on the Health and Human Services committee, said GOP leaders have restructured committee assignments in an attempt to obstruct issues that are important to Kelly.

"That's a huge concern," Holscher said.

Medical marijuana also failed to get a hearing in recent years, she said, leading to myths and misconceptions about the issue. She and Berger said cannabis could be used to treat those suffering from seizures and post-traumatic stress disorder, or as an alternative to medications with severe side effects.

In other health issues, the Kansas Chamber wants legislation that would authorize corporate physicians, and Ryckman said state investment in mental health services would touch the lives of people frequently served in hospital emergency rooms and county jails.

"That's probably the biggest bang for taxpayers' money," the House speaker said. "It's not just best for the person. It's best for the system."