Capitol Update: Rep. Lindsey Vaughn says Kansas legislature is out of excuses on Medicaid expansion

Rep. Lindsey Vaughn, a Democrat, represents Kansas' 22nd House District in Overland Park. File photo.

Last week the Kansas House saw its first opportunity to vote on Medicaid Expansion this session.

No Medicaid bills have been worked this year at the request of Republican House leadership, so this opportunity was a result of the Democrats bringing an amendment to the comprehensive budget bill on the House floor.

The carrier of the original bill challenged the Medicaid Expansion amendment under the rules of “pay-go,” meaning that if a legislator wants to “pay” for an additional line item in the budget something else relevant must “go.”

The Rules Committee Chair ruled the amendment allowable under pay-go due to an existing budget item for CHIP, the Children’s Health Insurance Program, which provides health coverage to eligible children through both Medicaid and separate CHIP programs.

The reason then given by the majority party for voting down the amendment was that it would take away the allotted money desperately needed for CHIP. This argument is misleading, because the current federal incentives for Medicaid Expansion would more than help pay for both expansion and CHIP program costs.

The other excuses for voting down Medicaid heard on the floor and common among the opposition are that we cannot afford it, that it leads to “government-funded abortions,” and that people should get jobs so they can get private insurance through their employer.

Medicaid expansion is paid for with a 90% to 10% federal-to-state match. By not expanding, Kansas has already forfeited an estimated $2 billion in federal funds.

Further, the federal government is currently offering an additional $460 million incentive under the American Recovery Plan for states that expand Medicaid. And finally, Gov. Laura Kelly proposed a plan this year to pay for the state’s obligation of expansion through the passage of medical marijuana.

Therefore, the real question is how can we not afford to expand Medicaid? Especially during a global pandemic.

Regarding the assertion of “government-funded abortions”, Medicaid only pays for abortions in cases of rape, incest, or the endangerment of the mother’s life. In Kansas, there were only four abortions paid for by Medicaid between 2013-2020.

I think most everyone can agree that allowing someone to get an abortion in these circumstances protects women.

And lastly, while some people receive good health care coverage through their employer, the availability has decreased significantly as America has shifted toward a gig economy and as people have lost their jobs due to COVID-19.

Medicaid expansion in Kansas would cover individuals up to 138% of the federal poverty level, which only equates to making $30,305 per year for a family of three. A family making this combined income likely has several barriers that they face every day, possibly working multiple jobs, keeping a roof over their head and getting their kids to school.

Access to high quality health care should not be something these families are forced to go without. Preventative health care always leads to better outcomes for patients and it significantly reduces uncompensated care costs from emergency room visits.

The only real remaining opposition is purely political, and that is a complete shame.

By expanding Medicaid, Kansas would ensure that another 150,000 people receive critical health care services, and it would also help rural hospitals stay open.

Four rural hospitals closed between 2016 and 2019, and this likely could have been prevented if Medicaid expansion had been passed. In addition to offering essential services, rural hospitals act as economic engines in rural communities, creating jobs and attracting and supporting businesses and residents.

Unfortunately, the Medicaid expansion amendment failed on the floor 78 to 46.

This legislation is long overdue and the time to act is now. Please contact your state legislators and let them know you support expansion.

As always, it is an honor and a privilege to represent the 22nd House District. If you ever have any questions or suggestions for me, I can always be reached at or

Thank you for your ongoing support.