How important is Medicaid expansion to Kansas?

Do the lives and health of tens of thousands of state residents hang in the balance? Are billions of dollars poised to rush into the state’s economy, supporting rural hospitals and creating new jobs? Is the only thing preventing that from occurring the ideological blindness of Kansas legislative leadership?

Until the last full day of the session, Saturday, May 4, we believed that moderate Republicans in the Kansas Legislature agreed with us on the critical importance of expanding KanCare. Rep. Don Hineman, indeed, contributed a column to this very page stating as much.

We believed what we were told.

Perhaps we should have been more skeptical. Because the events of that Saturday suggest that moderate Republicans don’t actually believe those things. Or, at the very least, that they’re not willing to put themselves on the line for a policy win that will benefit less-fortunate Kansans.

To recap: A coalition of moderate Republicans and Democrats in the House held the budget hostage for a day, hoping to force a vote on expansion in the Senate. Senate President Susan Wagle never seriously entertained the prospect, and the coalition splintered Saturday evening. Not only would there be no Medicaid expansion, but the budget itself had been revised to add strings to additional corrections funding. A child welfare oversight committee was also deleted.

In other words, moderate Republicans made about the worst deal possible. They claimed to want Medicaid expansion but ended up with no Senate votes on the policy, and a budget that was tangibly worse than the one they started with.

That’s not a negotiation. That’s giving up. Going into the standoff with the Senate, moderates should have been prepared to vote down each and every budget proposal on principle until Medicaid expansion was passed. It shouldn’t have mattered if the budget was terrible or perfect — the votes should have been no, each and every time.

Yes, it would have been risky. Yes, positions on committees could have been at stake. Yes, primary challenges may have resulted.

But if moderate Republicans believed what they said, if they truly believed in the benefits of expansion now, not next year, then they should have been willing to hang together and use the brute force of their numbers to bring the policy into being. Veto session was scheduled to last at least one more week. They could have taken up those days — and even more — fighting for expansion until Senate leadership buckled.

Would that have worked? Perhaps not. But moderates would have put up an honest fight. At the very least, they could have passed a budget that didn’t shirk on responsibilities to corrections and child welfare.


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