Could Johnson County officials help Kansas finally expand Medicaid? Gov. Kelly thinks so

As she tries yet again to push an expansion of Medicaid through the Legislature, Kansas Gov. Laura Kelly is hoping support from Johnson County officials can help influence state legislators to advance her proposal.

Kelly made a rare appearance at the Johnson County commissioners meeting on Thursday, where the board approved a proclamation in support of Medicaid expansion. The Democratic governor hopes it’s a strategy that will help her finally find success: Enlisting local officials in Kansas’ most populous county to persuade rank-and-file Republicans who support the policy to pressure GOP leadership to allow a vote when lawmakers return to Topeka next year.

“I’m just very grateful to the Johnson County Commission for going on record with support of this. They’re an influential group of folks here ... And we do need influential people in all of our communities to put pressure on their legislators to demand the right to vote on Medicaid expansion,” Kelly told The Star after a roundtable discussion in Overland Park.

Kelly told the group of health care and economic leaders during the roundtable that she hopes, “we’ll see other commissions do that. It’ll be imperative to get this passed this next legislative session.”

“We have tried five other ways of getting Medicaid expanded,” she later added.

Kelly has put forward a bill to expand Kansas’ Medicaid program, called KanCare, each year since she became governor in 2019. It was one of her early campaign promises. But Republican leaders in the Legislature have blocked the proposals from advancing.

The majority of Johnson County commissioners supported the proclamation, and Chairman Mike Kelly said the county board has made the program’s expansion a priority of its legislative platform since 2014.

“Now almost 10 years (later), we are one of only 10 states in the nation that hasn’t taken the opportunity to expand Medicaid,” he said. The chairman added that the expansion would provide access to health care for an estimated 150,000 people, including 7,000 in Johnson County.

The state’s current Medicaid program covers about 480,000 people, while about 260,000 people in Kansas do not have health insurance, Kelly said. The state could expand Medicaid to include any adult with an income at or below 138% of the federal poverty level, or anyone making less than $20,120.

But the governor’s visit wasn’t welcome by all. Johnson County Commissioner Charlotte O’Hara, a conservative, called it a “bully tactic” in an interview with The Star on Wednesday.

“To have a proclamation supporting this, in my opinion, it’s just not appropriate. We haven’t gone through the vetting process. We do not know what the repercussions of Medicaid expansion would be on our budget,” O’Hara said. “This is nothing but political theater. And attempting to put pressure on those who have issues with Medicaid expansion to get in line, I’m not going to do it.”

The Federal government pays 90% of the cost of expansion, with states covering the last 10%. In 2021 Congress included more financial incentives as part of a COVID-19 aid package, which would cut costs in the early years of the program if it passes.

GOP leadership in Topeka has been adamantly opposed to the program’s expansion in recent years. But Kelly hopes support from local Johnson County officials, in the county that continues to trend blue, could make a difference.

In Kansas, Medicaid remains restricted to certain groups, such as pregnant women, low-income families with children and individuals with disabilities.

“Under the current law, a single mother of two qualifies for KanCare when her annual income is at or below $9,500 per year,” the governor said. “That means that single mother, if she works 30 hours a week at a minimum wage job, she does not qualify for Medicaid as it currently exists.”

Kelly said that expanding Medicaid would create thousands of jobs, bolster hospitals during worker shortages and provide vulnerable residents with needed access to health care and mental health services.

Kevin Walker, a lobbyist with the Overland Park chamber, said during the roundtable discussion that, “We have to get the county commissioners and city councils to understand that and to connect those dots. We need to work with them and get them to talk with their lawmakers.”

Kansas is bordered by states that have already expanded Medicaid. Missouri did so after voters approved it in 2020. That’s not an option in Kansas. State law, enacted under former Republican Gov. Sam Brownback, requires legislative approval before the governor can expand the program.

The governor’s stop in Johnson County came on the heels of the rural Herington Hospital announcing its closure, about an hour-and-a-half drive southwest of Topeka. Kelly’s office said it is now the eighth hospital to close since Kansas has had the option to expand Medicaid.

Includes reporting by The Star’s Jonathan Shorman and Katie Bernard.