TOPKEA — Kansas Gov. Sam Brownback vetoed a bill to expand Medicaid in Kansas, one that was sent to his desk this week after a vote by both the House and Senate that would mean more federal funding for the program in the state that was supported by Kansas hospitals.
“I am vetoing this expansion of ObamaCare because it fails to serve the truly vulnerable before the able-bodied, lacks work requirements to help able-bodied Kansans escape poverty, and burdens the state budget with unrestrainable entitlement costs,” Browback said in a written statement.
The move does not kill efforts to expand medicaid in the state — the legislature could vote to override the veto.
Supporters of the bill launched an effort Thursday to override the veto in the House shortly after Brownback announced his action.
Kansas legislators have postponed a vote on overriding Republican Gov. Sam Brownback's veto of a bill that would have expanded the state's Medicaid program.
However they realized one of the bill's supporters was not present, and pushed to table the discussion indefinitely. The vote was 81-43.
“I am hopeful that there would be votes in the Legislature to overturn his veto,” said Val Gleason, CEO of Newton Medical Center. “... We have supported Medicaid expansion philosophically, at Newton Medical Center. To us it is the right thing to do. It would expand insurance coverage for an estimated 150,000 people in Kansas. For those of us who work in health care, we know and understand that people with health insurance coverage of some kind tend to do better and are healthier.”
Newton Medical Center and other Kansas Hospital Association members have supported an expansion of Medicad in the state.
But the 25-14 vote Tuesday in the Senate was two votes shy of the two-thirds majority necessary to override a veto. The House approved the bill last month on an 81-44 vote , three votes short of a two-thirds majority.
“If there are not enough votes to do that, that poses a real dilemma for health care providers in fulfilling their missions,” Gleason said. “ … [The Legislature] will have to do some work up there if they want it to pass.”
Though the bill appears to be short on votes for an override, and a vote for an override has been postponed, a vote for an override is expected.
That vote could come as soon as Monday.
"We are close on the numbers on that," said Rep. Tim Hodge (D-North Newton).
The bill vetoed by Brownback would expand the state's Medicaid program for the poor, disabled and elderly so that it would cover up to 180,000 additional adults who aren't disabled.
The bill contains a provision that adults need to work, about 20 hours per week, to be eligible for this expansion of Medicaid.
“It is a hand up, not a hand out,” Gleason said. “We have watched this in other states. This model has seen some successes in other places around the country. We see this will improve health and protect our local hospitals.”
The bill would not have passed the Kansas Legislature last year. At least eight new state senators replaced Republicans who were likely to have opposed expanding Medicaid. In the House, the same could be said for at least 20 members.
Former President Barak Obama's Affordable Care Act encouraged states to increase the number of people eligible for Medicaid by promising to pay most of the costs. A total of 31 states, including some led by GOP governors, have expanded Medicaid.
Kansas critics argued that expanding Medicaid still would be too expensive for the state, which is facing projected budget shortfalls of more than $1 billion through June 2019 following massive personal income tax cuts championed by Brownback.
Kansas' Medicaid program covers about 377,000 poor, disabled and elderly residents, but poor adults under 65 who aren't disabled and don't have children aren't eligible. Brownback's administration projected the extra costs of expanding the program at $66 million total for the state's 2018 and 2019 budgets
"There's no question in my mind that this would be a huge cost to the state," said Shawn Sullivan, the governor's budget director.
But the Kansas Hospital Association projects a net gain for the state, arguing in part that an influx of federal dollars would ripple through the state's economy. Hospitals were a crucial part of the lobbying for the bill; supporters believe the expansion would prevent some hospitals from shuttering.
"This will restore funding for hospitals that were swept out by the Affordable Care Act. Money was swept out of Kansas with the promise it would come back through Medicaid expansion. That has not happened," Gleason added.
According to the KHA, this expansion would bring $2.87 billion to the state between 2018 and 2020. In addition, out of 107 rural hospitals in Kansas, 31 are labeled at risk of closure.
However, Brownback said the bill would mean support for Planned Parenthood, something which led him to veto the bill.
“Most grievously, this legislation funnels more taxpayer dollars to Planned Parenthood and the abortion industry. From its infancy, the state of Kansas has affirmed the dignity and equality of each human life. I will not support this legislation that continues to fund organizations that undermine a culture of life.”
That did not resonate with Hodge, who saw something different in the expansion of Medicaid.
"Nurses, doctors and health care workers, they live out in small towns," Hodge said. "If you live in small towns, there is no reason you should be voting against this. Your vote is against your own town if you are voting against this."
— The Associated Press Contributed to this report