- Kansas is the latest state to agree to expand Medicaid eligibility under the Affordable Care Act.
- The expansion, the result of a deal brokered between the Democratic governor and the Republican Senate majority leader Thursday, is expected to insure up to 150,000 more Kansans.
- The decision is one of a wave of red state holdouts against Medicaid expansion having a change of heart.
The 2010 midterm elections led to a wave of newly elected Republican lawmakers flipping statehouses red. The 2018 midterms did the same for Democrats. And in Kansas — one of the reddest states in the Midwest — moderate Democratic state senator Laura Kelly beat GOP candidate Kris Kobach in 2018 for the governorship by 4.5 percent points.
One of Kelly’s campaign promises was to expand Medicaid under the Affordable Care Act. The state legislature had actually approved an expansion in 2017, but it was vetoed by Kelly’s predecessor, Republican Sam Brownback.
While it took a year into Kelly’s term, she delivered this week, announcing a deal brokered with Senator Majority Leader Jim Denning to move forward with the expansion. The GOP-dominated legislature is expected to approve the measure, which also includes incentives to keep some 50,000 Kansans with commercial coverage who would be eligible for Medicaid from switching plans. It does not include a mandatory work provision.
Kansas joins a flurry of red or red-leaning states that have either expanded Medicaid through their legislatures or via voter initiative. Utah, Idaho and Nebraska moved forward last year.
Under the ACA, states can expand Medicaid coverage from 100% to up to 138% of the federal poverty level. That's about $17,000 for an individual, or $29,000 for a family of three. The federal government pays up to 90% of the expansion cost.
Many states have found the economic arguments against expanding the health coverage net no longer resonate with voters, even as the ACA continues to be challenged in federal court. Bipartisan support in Kansas grew given that four rural hospitals closed in the state since 2015, the New York Times reported.
"This agreement is clearly the most significant progress we have seen in the Medicaid expansion debate in Kansas," said Tom Bell, CEO of the Kansas Hospital Association, in a statement. "The fact that Gov. Kelly and Sen. Denning have agreed in principle on a plan is momentous. It represents real compromise and is undoubtedly the best, and maybe the only, way to get this through the legislature."
Save for Louisiana and Arkansas, the Southern states – including populous Texas and Florida – comprise the majority of the remaining holdouts for expanding Medicaid.