Over the past year, several polls have asked Kansans if they support Medicaid expansion in the state, and all of them have demonstrated widespread support. Last October, a Fort Hays State University survey revealed that 62 percent of respondents were in favor of expansion. A few months later, the American Cancer Society Cancer Action Network asked Kansans the same question, and reported even greater support: 82 percent. In April, the same organization (along with the American Heart Association) found that 66 percent of Republicans endorsed expansion.
If these polls didn’t make Kansans’ priorities clear, the crowds of people at the Statehouse should have done so. When lawmakers held hearings on expansion, more than 160 advocates, health care providers, business leaders and concerned citizens testified in favor of providing Medicaid to 150,000 of their fellow Kansans. The opposition, on the other hand, was sparse: only five people showed up. When lawmakers voted on expansion shortly thereafter, they demonstrated that they took their constituents’ wishes seriously: the tally was 81-44 in the House and 25-14 in the Senate. But they couldn’t override Gov. Sam Brownback’s veto.
Medicaid is one of the issues that should remind the rest of the country that Kansas isn’t the politically homogeneous state it’s often made out to be. Kansans know their governor has given up hundreds of millions of federal Medicaid dollars (the Kansas Hospital Association estimates that the total is around $2 billion). They know they live in one of only 19 states that refused expansion. They know expansion would put health care providers — particularly vulnerable rural hospitals — in a much stronger financial position.
Kansans also know that the economic impact of Medicaid expansion isn’t as straightforward as critics like Brownback would have them believe. This is why business owners, chambers of commerce and economic organizations across the state have declared their support for expansion. A 2013 brief by the Kaiser Family Foundation “assessed specific findings from 32 studies in 26 states” and found that expansion increased “state output, Gross State Product (GSP) and state and local revenues.” KFF also reported that the studies demonstrated a “positive effect on jobs and earnings.”
The gubernatorial race offers Kansans an opportunity to reiterate these points. While Democratic candidates are almost unanimously in favor of Medicaid expansion, there are divisions among Republicans. For example, Lt. Gov. Jeff Colyer and former state senator Jim Barnett are both physicians, but they disagree on expansion — Colyer has been resolute in his opposition, while Barnett argues that eligibility should be broadened. Secretary of State Kris Kobach, Ken Selzer and Wink Hartman all oppose expansion, while Ed O’Malley says his support is contingent on whether expansion would be cost-neutral (and if the federal government pulls out, he wants Kansas to do the same).
Bob Beatty is a political scientist at Washburn University, and he points out the significance of this diversity of opinion: “Where the candidates stand on Medicaid expansion may be one of the key differentiating factors in this primary.” This would be a healthy development. Considering its significance for 150,000 Kansans — as well as hospitals and businesses around the state — Medicaid should be a major issue during this campaign. We should demand robust debate, and we can’t allow candidates to obscure the facts (for example, those who oppose expansion often cite its costs and ignore the economic benefits mentioned above).
Kansans support Medicaid expansion, and we need to remind our future governor of this fact.
Members of The Capital-Journal’s editorial advisory board are Zach Ahrens, Matt Johnson, Ray Beers Jr., Laura Burton, Garry Cushinberry, Mike Hall, Jessica Lucas, Veronica Padilla and John Stauffer.