Amid cattle and pickups at the Fort Hays State University Farm, a chilly wind whipped Jerry Moran’s blue flannel shirt on Friday afternoon as the U.S. Senator spoke earnestly about an issue he considers important to Kansans.

“If you’re a person who cares about the future of rural communities across our state, there are lots of factors that are important, but almost at the top of the list is access to healthcare. Maybe at the top of the list is healthcare,” said Moran. “Our hospitals, 128 of them in Kansas, I’ve visited each and every one of them, and without exception, they are hanging on by a thread.”

In advance of riding with university professors to tour the farm south of town off the U.S. Highway 183 Bypass, Moran answered questions from the press on various issues, including expansion of Medicaid in Kansas.

Kansas is one of 14 states to turn down federal dollars to help expand Medicaid so the insurance program can cover more poor people. The Kansas Legislature in previous sessions voted for expansion, but former Republican Gov. Sam Brownback vetoed it. As a result, the state’s healthcare providers have missed out on about $2.9 billion in federal money.

“Every amount of revenue is important,” Moran said of Kansas hospitals. “From a federal point of view, we have left in place the opportunity for a state to expand Medicaid, so that law still exists, and a state could make a decision to expand. But that decision is going to be made in Topeka.”

The two candidates competing in the Nov. 6 general election for the open seat in the House of Representatives 111th District, which includes Hays and parts of Ellis County, have taken different positions on Medicaid expansion. Democrat incumbent Eber Phelps previously voted in favor of it and says “absolutely” Medicaid must be expanded.

Moran mentioned, however, that some are worried the federal government’s contribution will disappear, leaving states holding the bag. Phelps’ opponent, Republican Barb Wasinger, currently an Ellis County Commissioner, has said she questions whether the federal government would continue to reimburse at 90 percent, noting expansion will cost the state $56 million to add 150,000 people.

“There’s a risk to that,” Moran brought up, mentioning his own hometown. “So Kansas has to decide where they draw the line between the risk of involving themselves in a federal program that the federal dollars will, at some point in time, or could, at some point in time, go away versus the dire circumstances that we have in trying to keep hospital doors open in Plainville and other places across the state.”

Medicaid expansion isn’t the only thing hurting Kansas hospitals, though, Moran said. A bigger blow was the Budget Control Act of 2011 that cut Medicare provider payments 2 percent across-the-board to save the federal government $1.2 trillion.

“That amount of money is larger than Medicaid expansion,” Moran said. “So I’ve got my focus on trying to fix a problem that the federal government created.”

The sunny November day Friday afternoon allowed Moran and university professors to talk outside on one of the farm’s chalk roads. Moran addressed the notion of U.S. Secretary of Agriculture Sonny Perdue to move two agencies of the U.S. Department of Agriculture out of the Beltway to the Midwest.

The move will bring hundreds of high-paying jobs to whatever region is chosen for the USDA’s Economic Research Service and the National Institute of Food and Agriculture. Moran said Perdue wants a decision early in the year, probably January, which would then prompt the Government Services Agency to look for the right location and scout economical properties.

So far, Kansas City, Leavenworth, Wichita and Lawrence have expressed an interest. Hays has not, to his knowledge. Besides the economics, GSA will no doubt look for locations with good transportation networks, including an airport, as well as intellectual capital and an attractive place to live, Moran said.

“With GSA we’re going to be pushing this region, but I don’t anticipate getting involved in exactly which site,” he said. “USDA is going to turn it over to GSA and say ‘find us a spot.’”

Snagging those agencies would bring a broader benefit than a few hundred jobs, he said, but also expand on the existing agriscience environment.

“If USDA puts their stamp of approval on our region,” he said, it brings others who want to invest and who want to be a part of it.

Asked about President Trump’s plan to end birthright citizenship by Executive Order, Moran said the 14th Amendment of the Constitution provides that right, although there is some question about how the amendment can be interpreted.

“But under any circumstance, I believe that would take a Constitutional amendment, or a court decision, and that would require involvement of Congress and the states,” Moran said. “So any change would be something that can’t be done with the stroke of a pen from the White House.”

Asked how Congress will look after Tuesday’s election, Moran said the answer to that question depends on who shows up to vote on Tuesday.

“I always think that candidates matter, and they do, but there are also national trends at play here,” Moran said. “The feel to me by what I hear from the people I talk to on the street, what I see happening in Kansas, and what I hear on national news and media, and my colleagues who are traveling across the country, is the Republican majority in the Senate should hold or gain a seat or two, and the House should be very, very close, I just would tip it in favor of the Democrats.”