Republicans seething over a policy shift that makes it easier for some Kansans to obtain food stamps are worried Gov. Laura Kelly could attempt to expand the state's Medicaid program through administrative action.
It isn't clear whether Kelly, a Democrat, could deploy Medicaid expansion in defiance of a 2014 law that specifically requires legislative approval, and there is no indication her administration is considering ways to do so.
Still, Republican leaders point to a Kansas Department for Children and Families directive to use federal exemptions for work requirements with the Supplemental Nutrition Assistance Program as evidence the governor is willing to bypass restrictions in state law.
“The administration has proven it is willing to use unlawful executive action to allow able-bodied adults without dependents to continue receiving SNAP benefits," said House Majority Leader Dan Hawkins, R-Wichita. "We simply cannot trust it to respect the law when it comes to Medicaid expansion."
Mike Kuckelman, chairman of the Kansas Republican Party, said the party is working with legislative leadership to prepare for the possibility that Kelly will attempt to use executive action to expand Medicaid in Kansas.
"Kansans should be vigilant that Gov. Kelly may attempt to expand other programs, including Medicaid, in a manner that violates Kansas law or intrudes upon the Legislature’s right to legislate," Kuckelman said. "This is an extreme overreach of power, and no Kansan should be comfortable with a governor that governs in this dangerous manner.”
Kelly made Medicaid expansion a top goal of her administration, highlighting the potential economic impact and support from chambers of commerce across the state.
The Kansas Health Institute estimates an additional 130,000 low-income adults and children would gain access to health care coverage through Medicaid expansion. The estimated cost to the state would be $47.4 million in the first year, but the investment would unlock a billion dollars in federal funding that could spur the economy and boost tax collections.
Democrats in the House joined moderate Republicans in forcing passage of an expansion package earlier this year, but Senate leadership batted back attempts to move the legislation forward. Senate Majority Leader Jim Denning, R-Overland Park, instead offered to produce a new bill through an interim Senate committee and bring the issue to a vote in January.
The governor's office didn't rule out the possibility of taking administrative action on Medicaid expansion but made it clear that the preferred route is through the Legislature.
"It’s no secret," Kelly said, "that I was disappointed when one GOP leader insisted on playing politics and blocking the will of the people as lives hung in the balance. But I’m encouraged that Sen. Denning has publicly promised to finally allow full debate and a vote on Medicaid expansion in 2020. I’ll continue to work with all Kansans to ensure he keeps his promise.”
A law passed in 2014 served as insurance in case Republican Gov. Sam Brownback failed to win re-election. The statute says Medicaid eligibility can't be expanded "unless the Legislature expressly consents to, and approves of, the expansion of Medicaid services by an act of the Legislature."
In 2017, the Legislature passed a Medicaid expansion plan. Brownback vetoed the plan, and its support fell short of the two-thirds majority needed to override the governor.
This year, Denning attempted to strengthen the 2014 law by adding more restrictive language to the state budget, but his amendment was stripped during negotiations late in the session.
Senate Minority Leader Anthony Hensley, D-Topeka, said he doesn't think it is possible to expand Medicaid without legislative approval.
"I would seriously doubt that Gov. Kelly would attempt to circumvent the law," Hensley said. "There's a conspiracy theory at work here that is really misplaced."
April Holman, executive director of the Alliance for a Healthy Kansas, which lobbies for Medicaid expansion, said she doubts administrative action is being seriously considered.
"This would be at best a risky move," Holman said. "We would like to see people actually have access to insurance to help them receive affordable health care, so we don't want to see something that would jeopardize that."
Republican leaders lurched at the opportunity to criticize the governor in the wake of the DCF decision to use a federal "exemption" on work requirements. Legislation passed in 2015 blocks the agency from seeking a federal "waiver," which is granted when there aren't available jobs, as was the case during the 2008 financial crisis.
Federal rules require able-bodied adults who receive food assistance to work 20 hours per week, but the requirement only applies to 85 percent of the state's caseload. The Kelly administration has embraced the wiggle room for the remaining 15 percent — an "exemption" in the parlance of federal bureaucracy that wasn't utilized under the administrations of Brownback and Gov. Jeff Colyer.
“Sadly, Laura Kelly is following the socialist, Democratic playbook by violating the law in attempt to grow the welfare state in Kansas," said Senate President Susan Wagle, R-Wichita. "While our governor would prefer to keep people dependent on government programs, the majority of Kansans understand the need to provide a helping hand while ensuring that able-bodied adults become contributing members to society and achieve self-sufficiency.”
Kelly was a state senator from Topeka when the waiver restriction was passed in 2015.
Dena Sattler, spokeswoman for Kelly, said the governor "remembers the spirit in which some members of the Legislature supported this law, but she is more concerned with the actual law as written and with the spirit of DCF’s work to provide food assistance to those in need.”
Karen Siebert, a public policy adviser for Harvesters, the community food network, said the Kelly administration clearly was acting within the bounds of federal guidelines. Harvesters supports the expansion of the safety net, Siebert said.
Several vulnerable population groups need food assistance but fail to meet the work requirements, Siebert said. They include 18-year-olds who are leaving foster care without a family, homeless veterans, convicted felons, victims of domestic violence and people who are disabled but haven't yet received disability status.
Siebert said she was bothered by language that implies some people "refuse" to meet the work requirements.
"Many people in that situation have significant barriers to employment," Siebert said. "Most people, if you can work, you do work."