Capitol Update: Why hasn’t the legislature voted on Medicaid expansion?

Overflow seating outside the hearing on Medicaid Expansion. Photo Credit Dan Brennan
Overflow seating outside the hearing on Medicaid Expansion. Photo Credit Dan Brennan

To keep our readers better informed about the state government actions that impact our communities, we feature an update columns each Monday from one of northeast Johnson County’s elected officials: Rep. Barbara Bollier, Rep. Stephanie Clayton, Rep. Jarrod Ousley, Rep. Melissa Rooker and Sen. Kay Wolf. Rep. Ousley submits this week’s update:

In a recent forum, I was asked why we haven’t voted on Medicaid Expansion, and I responded it had something to do with politics.  As a recent poll conducted by the Kansas Hospital Association indicates that two thirds of Kansans support Medicaid Expansion, I will try to explain.

rep_ousley_jarrod_1A common thread running throughout the course of this session, has been the successes of a few, powerful groups:  (1) the American Legislative Exchange Council (ALEC); (2) Americans for Prosperity (AFP); (3) the Kansas Policy Institute (KPI); and (4) the Kansas Chamber of Commerce (the Kansas Chamber).

ALEC asserts it is a nonpartisan public-private partnership of America’s state legislators, the private sector, and the general public.  Its Board of Directors includes Speaker of the House, Ray Merrick, and Senate President Susan Wagle.

See an email from Merrick regarding ALEC below. The email was sent by Michelle Doner, on behalf of Speaker Merrick (misspelling his name).  A follow up email apologized for the misspelling.  I’ll note that $5000 – $100,000 sponsorships do not meet every budget:

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ALEC’s four member Board of Scholars includes Art Laffer, whom the Governor paid $75,000 of state funds to craft our failed tax policy, which mostly benefits a very small number of wealthy individuals and businesses. Primarily, ALEC provides draft bills and resolutions for legislators to submit in their home state capitols.  For example, a quick search reveals ALEC’s draft resolution to block the expansion of Medicaid.  ALEC’s corporate members include Koch Industries.  ALEC asserts it does not lobby on behalf of its draft policy.

However, the other three groups do.

AFP’s goals include “leaving our children with more financial security by putting the brakes on government spending.” AFP has a list of key issues for each state, and in Kansas this includes stopping the expansion of Medicaid.  AFP notifies legislators prior to a vote if it is considered a key vote, and then pays for “informational postcards” to educate their constituents on how they voted.  The Washington Post recently proposed AFP may be the country’s third largest political party.

KPI vocally supports reduced taxes and opposes government spending.  The President, and primary lobbyist for KPI, Dave Trabert, co-chairs the Education Finance Joint Working Group for ALEC, and speaks for the Friedman Foundation for Educational Choice, promoting privatization of education.  He testifies regularly in committee hearings and attends public forums to promote KPI’s agenda.  Prior to his work as a professional lobbyist, Mr. Trabert, originally from West Virginia, had a career as a television station manager.  KPI submitted testimony against expanding Medicaid.  For more on how ALEC, KPI and AFP work together, I suggest this MediaMatters article.

Finally, the Kansas Chamber promotes a legislative agenda and kindly informs legislators when a vote is key.  The Kansas Chamber’s position on health care is vague, but focuses on lowered costs.  You may recall an email sent by my respected colleague Rep. Scott Schwab, regarding his loss of the Kansas Chamber’s endorsement.  Local Chambers do at times disagree with the Kansas Chamber.  For example, 14 local Chambers, including Overland Park, Northeast Johnson County, Salina, Emporia, Shawnee and Desoto, recently co-signed a letter to the Governor opposing balancing our budget strictly through spending cuts, citing the importance of excellent schools, good highways and quality of life to businesses.

Unfortunately, when these four groups take a side on an issue, it becomes difficult for Kansans to succeed against them.  In March, after two years of blocking a House Committee hearing for Medicaid Expansion, one was finally granted after a procedural maneuver almost forced a vote on the issue. Proponents included care providers, the Kansas Hospital Association, and Kansans who are too poor to qualify for subsidies and are trapped in the coverage “gap.”  The hearing was packed, with the crowd spilling into the hall, as supporters explained that expansion would provide 150,000 Kansans access to health insurance, and is desperately needed to keep rural hospitals open.

The procedures stifling discussion on the budget are likely being used to prevent a Medicaid Expansion debate on the House floor, as the rules would otherwise allow it as the subjects are related.  As with other policies discussed this session, including moving elections, changing judicial selection, and the Renewable Portfolio Standards, the success or failure of legislation has been linked to whether or not it was supported by one or more of the four organizations I reference above, and not by whether it was supported by Kansans.

Thank you for the opportunity to serve the 24th District.  I can be reached at jarrod.ousley@house.ks.gov at www.facebook.com./JarrodOusleyforthe24th  and at 785-296-7366.