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Minutes for HB2556 - Committee on Health and Human Services
Short Title
Expanding medical assistance eligibility and enacting the cutting healthcare costs for all Kansans act.
Minutes Content for Wed, Mar 20, 2024
Will Carpenter, Representative, Kansas Legislature, provided testimony in opposition to HB2556 (Attachment 17). The biggest concern with Medicaid expansion is that the focus then falls on the 150,000 able bodied individuals it is for. The focus should be the individuals that are on waivers and wait lists. Data was provided on the various waivers and their waitlists. Funding should be focused on these individuals. If budgets cuts occur in the future, and they will at some point, regular Medicaid will be cut first because of the 60/40 match on regular Medicaid versus a 90% match for the full expansion folks. Examples were provided of states that have expanded and the the results of uncompensated care.
Beverly Gossage, Senator, Kansas Legislature, provided testimony in opposition to HB2556 (Attachment 18). Senator Gossage focused her testimony on her area of expertise, which is the individual and group insurance market. According to KHI 106,000 non-disabled adults who earn zero up to 138% of the FPL could be added through Medicaid expansion. Regarding health insurance, KHI reports over 68,000 of them are currently insured through an employer or private insurance. In fact, if these individuals earn at the the FPL, they have access to affordable health insurance coverage through healthcare.gov. Regarding those in the Federally Facilitated Marketplace (FFM) earning 100-138% of FPL, they have access to zero premium plans with enhanced subsidies, particularly those in states that have not expanded Medicaid. Over 50% receive premium subsidies plus cost saving subsidies that reduce the out of pocket costs for claims. An example was provided showing an individual earning the poverty level and his out of pocket costs for insurance in a state without expansion and the effects to these costs if Medicaid is expanded. Expansion removes the subsidies and increases the cost.
Senator Gossage responded to questions from the committee.
Sam Adolphsen, Visiting Fellow, Opportunity Solutions Project, provided testimony in opposition to HB2556 (Attachment 19). It was noted that the bill before the committee is 100% the Medicaid expansion that was offered by the Obama administration 10 years ago. The plan would remove individuals already covered by a fully subsidized private plan causing the reimbursement rates to hospitals to drop. It would also give the administration to operate a "private option" for the state to pay premiums for some individuals. This has failed in states that have attempted it. The bill also adds able bodied individuals to Medicaid. This would also make the state dependent on approval from the federal government.
Mr. Adolphsen responded to questions from the committee.
Michael Cannon, Director of Health Policy Studies, Cato Institute, provided testimony in opposition to HB2556 (Attachment 20). In 2013, Mr. Cannon testified here against Medicaid expansion. In 2019, he was a participant in a round table discussion on expansion in which he stated his opposition. Mr. Cannon's reasons for opposition were listed. There has been no research done that would compel Kansas to expand Medicaid. Several reasons were provided suggesting that the tax burden on Kansans would be much larger.
Mr. Cannon responded to questions from the committee.
Brittany Jones, Director of Policy and Engagement, Kansas Family Voice, provided testimony in opposition to HB2556 (Attachment 21). Given the opportunity, there is an opportunity for a court in Kansas to apply the Hodes decision to compel the state to strike down the state's prohibition on taxpayer funding of abortions. The Alaska Supreme court forced that state to pay for abortions through Medicaid. 17 states have Medicaid paid abortions. The question is do Kansas taxpayers really want the potential to pay for the majority of abortions in the state.
Dean Clancy, Senior Health Policy Fellow, Americans for Prosperity, provided testimony in opposition to HB2556 (Attachment 22). Kansas has taken a personal option approach to health insurance. The state also has safe harbor laws. There is also no certification of need laws. Expansion also does not have a significant impact on rural hospital closures. The 90 percent match rate is now a target for federal budget cutters.
Written only testimony in opposition were submitted by the following:
Debbie Detmer, Private Citizen (Attachment 23)
Gaylene Van Horn, Private Citizen (Attachment 24)
James Franco, Kansas Policy Institute (Attachment 25)
Jeanne Gawdun, Director of Government Relations, Kansans for Life (Attachment 26)
Jill O'Connor, Private Citizen (Attachment 27)
William Wilk, Senior Director of Government Affairs, Kansas Chamber (Attachment 28)
