Hello from Topeka. This week we are spending all day on the house floor debating and voting on bills that have been working their way through the committee process. This is the first year of the biennial Legislature so if a bill did not get brought up for a vote by the full committee, it still could be next year. I appreciate the texts, emails and phone calls regarding issues in the Legislature and always encourage folks to let me and other elected officials know your thoughts and concerns. Last Friday, it was good to have the Rooks County high school seniors at the Capitol for the annual Legislative Encounter sponsored by the Rooks County Farm Bureau. This week we honored the Ellis High School Cheerleading squad on the house floor for winning the 1A/2A Spirit Game Day Championship for the second year in a row and Coach Kristi Bittel for being named Midwest Coach of the Year for Girls Spirit for Kansas and the surrounding states.
Last week the focus was on HB 2066: Medicaid Expansion. Using a procedure called a “gut and go” some members of the House forced debate on the issue of Medicaid Expansion. Following debate and several amendments the Democrats and some Republicans voted to move the measure to the Senate.
No one knows exactly what Medicaid expansion will cost our state. Estimates range from $28 million per year, per the governor, to $50 million per year, per the Kansas Health Institute. The fact is no state has accurately met their cost estimate for expansion. All of them have underestimated the fiscal impact. I could not in good conscience sign our state up for a program with an unknown fiscal impact.
I have serious concerns with this measure. Chief among my concerns is the potential crowd out of Kansans who are already covered by Medicaid — that includes seniors, the disabled, children in low-income families, low-income pregnant women and very low-income adults — some of whom are on waiting lists for services. With expansion, work-eligible adults would jump the line, becoming eligible for services before those who have been waiting.
Medicaid expansion is advertised as a magic pill that will save rural hospitals. That simply isn’t true. While expansion may bring in additional dollars the lion’s share of the money will go to urban areas not rural hospitals.
I have been consistent in my opposition to Medicaid expansion and after the vote went to the well of the House to explain my vote to the citizens of Kansas:
“Mr. Speaker, I vote no on HB 2066 as amended. While health care is important to the medical providers in the 110th District and all Kansans, I have remained a steadfast opponent of Medicaid expansion in Kansas. I will continue to work on solutions to keep our rural hospitals viable, but this is not the answer when we simply do not know what the costs will be or how it will be will be paid for. Priorities as legislators are formed by talking with our constituents and colleagues then doing what we think is right for our district and state. While I was not on the prevailing side, my desire to make Kansas a great state is not diminished.”
This measure would move 55,000 Kansans from private health insurance to government dependence. Just like when President Obama told people, “if you like your doctor you can keep your doctor” and then immediately broke that promise, Medicaid expansion will result in reduced options available to Kansans and leave them with fewer choices and less quality in their healthcare.
Health care is a complex problem and no single policy will address all of the challenges we face, not even expansion. We should use extreme caution when expanding a government program because they are rarely reduced and often do not contain incentives to ensure improvement and innovation for the benefit of those who use them. Sadly, such caution was not exercised with this measure.
Ken Rahjes represents the 110th district in the Kansas House of Representatives.