Republican Kansas statehouse candidates on the issues: Expanding Medicaid in Kansas

Medicaid expansion supporters rallied at the Kansas Statehouse on the second day of the 2020 legislative session. Photo credit Stephen Koranda / Kansas News Service.

Last month, we asked our readers what issues they wanted to hear the candidates running for office address ahead of this summer’s primary elections. Based on the input we received, we developed a five-item questionnaire for Republican candidates running for seats in the Kansas House and Senate.

We’ll be publishing the candidates’ responses to one item per day each day this week. Today we’re publishing the candidates’ responses to item two:

Kansas is among the 14 states yet to adopt a Medicaid expansion bill under the provisions of the Affordable Care Act. Do you support Medicaid expansion in Kansas? Why or why not?

Kansas Senate District 10

Mike Thompson (incumbent)

I do not support Medicaid Expansion. Expanding Medicaid to able-bodied adults would do nothing to help those currently on the program, which has a very long waiting list. Our efforts should be focused on shrinking those lines first. Adding a new entitlement program would also be very expensive and could trigger future tax increases, particularly if the federal government would lower the percentage it covers. I do believe we need to explore more health care reform that is consistent with free-market principles by providing people access to affordable, quality health care.

Tom Cox

Medicaid Expansion has been one of the most controversial and misunderstood issues over the last few years. The federal government allows states to expand Medicaid and will pay 90% of the cost, while the state is responsible for the remaining 10%. We have been paying since before 2012 for expansion in the form of taxes and lack of federal funds to our hospital system, but since we have failed to expand it, we have received zero of those dollars back.

In late 2019 Republicans put a plan together to expand Medicaid to bring in the federal dollars and help provide between 100,000 and 150,000 low-income individuals access to healthcare. The principle argument against expanding Medicaid has been concern of cost to the State budget to cover the 10%.

The Republican plan ensured that the cost to the State would be $0. We did this by building a coalition of those who supported and benefited from expansion. The cost of expansion to the state is an estimated $37 million a year. The hospitals benefiting from expansion agreed to pay for the bulk of that and additionally there would be a premium of no more than $25/month for those adding to expansion to cover the rest. In exchange this more than $500 million to the state. That money circulating in our local economies and helping to reimburse healthcare providers could actually provide a net-positive revenue for the state.

I understand why people are concerned with expanding Medicaid. It is another government program and I know some people oppose expanding these types of programs. But the reality is, expansion is not going anywhere at the federal level. A majority of Republican held states have long-since expanded. Even Vice-President Pence expanded Medicaid while he was Governor of Indiana.

The second principle argument against expansion is the fear that the federal government decides to lower reimbursement below the 90%, which could increase the states cost substantially. To alleviate this concern a clause was added that if the federal government lowered reimbursement below 90% it would automatically end the program in Kansas unless the legislature passed a new law allowing expansion to continue.

I supported and will continue this version of Medicaid Expansion. I believe it will add jobs to Kansas, help reduce the costs of private insurance by better compensating healthcare providers, and provide better health outcomes for impoverished Kansans.

Kansas Senate District 11

Kellie Warren

Our Medicaid program is broken. For example, I was just speaking with a mom about her young daughter who has a disability. Her daughter has been one of the four or five thousand Kansans on the Medicaid waiting list, waiting for benefits. Like too many others, she said it’s hardly worth putting her daughter on the waitlist, it would take so long to get benefits, if ever.

As such, I am opposed to Medicaid expansion primarily because it harms the population of Kansans like that little girl, who Medicaid was intended to help: the elderly; disabled; children; and pregnant mothers. It makes that population compete for access to healthcare with the expansion population: persons who are 19-64 years old, who are capable of working, and without any dependents. I believe that will lead to rationing of healthcare, and I don’t believe that’s fair. It will also lead to a bigger tax burden on those who can least afford it – our seniors, the middle class, and the working poor.

What is fair is making sure those who Medicaid is intended to benefit actually receive benefits. What is also fair is expanding free-market affordable healthcare options like the Farm Bureau Health Plans I voted for as a State Representative, and Health Savings Accounts. As your senator I will work with and encourage Congress to expand Health Savings Accounts and to amend the Affordable Care Act so that it is actually more affordable.

John Skubal (incumbent)

I support a Medicaid expansion bill in Kansas. We have approximately 130,000 Kansans without health care. When this group needs health care, they typically go to emergency rooms which are considerably more expensive than a doctor’s office. Doctors in the ER have no history on these individuals and may never see them again to follow up on their care. Kansas has turned down 3 billion dollars for Medicaid expansion from the federal government which would have helped hospitals in both urban and rural communities in our state.

Kansas House District 18

Calvin Vandegrift

I do not support Medicaid expansion in the state of Kansas for two reasons, the first being that Medicaid expansion could potentially lead to tax payer funded abortions in our state, (this is an issue that Kansans for Life has voiced concern over in the past), and the second being that I am opposed to the Affordable Care Act entirely to begin with. If elected, I would work to introduce legislation to shrink the size of government in the state of Kansas.

Cathy Gordon

I have served as a Medical Missionary to over 40 different countries. I have witnessed and participated in health systems that were government funded. Missing components included quality, excellence, opportunity and delivery of the quality health care. It was “just a job for the health care providers and staff. It is not a plan for America, the public should have the right to choose. I am NOT in favor of Medicaid expansion and government involvement in health care delivery. I also oppose mandated employer-based health care coverages or payments thereof.

A solution to our current Medicaid cost reduction involves increasing the role of Nurse practitioners in Medicaid delivery by removing restrictions such as lower reimbursement and physician signatures. Kansans should decide their health care provider and health insurance decisions. I will promote an environment that fosters competition and choice in both insurance and providers, including providers, telemedicine, and safety-net clinics.

Kansas House District 20

Jan Kessinger (incumbent)

We now are down to Kansas being among only 13 states who have not approved expansion with Oklahoma approving it in early July.

I have long-been a promoter of Medicaid Expansion. Kansans have paid out more than $4.1 BILLION in Medicaid Expansion taxes. We have received ZERO dollars in return while we subsidize healthcare in other states. Meanwhile, 150,000 Kansans go without health coverage. They use the emergency room as their primary physician and if they cannot afford to pay, they don’t have to…so those who can pay pick up that tab. Additionally, the un-insured go without preventative care and that results in higher health costs as illnesses progress from the easily treated to the expensive to treat level.

The bi-partisan plan that was not voted on included a work referral program, required recipients to pay monthly premiums to offset costs and with hospital cooperation was to add under $10 million a year while helping 150,000 people.

Frankly, Medicaid Expansion has become political and partisan for no good reason. We must set aside partisanship and do what is right for those who would benefit a lot with little to no additional cost to Kansans. It is good for the health of Kansans and good for the economy by creating jobs.

Jane Dirks

I am opposed to Medicaid expansion. As an alternative, we need to expand health care choices in the private sector, short term medical plans and encourage the federal government to expand health savings accounts. There should be free market alternatives so people can purchase affordable, portable, plans that meet their needs. Medicaid was never meant to cover able bodied people of working age who are not working. This expansion would do that and move many people from government supported plans that they have to Medicaid and this would overwhelm the few doctors that are accepting Medicaid patients.

Tomorrow we’ll publish the candidates’ responses to item three:

What should the state government be doing to bring more good jobs to Kansas and support the growth of the state’s economy?