TOPEKA, Kan. (AP) — Gov. Sam Brownback's allies have raised the potential expansion of the state's Medicaid program as a campaign issue in the days before Tuesday's election decides races for the Kansas Legislature, with conservative Republicans seeking to bind Democrats to President Barack Obama and the federal health care overhaul.
The federal law enacted in 2010 contemplates an expansion of Medicaid to cover millions of uninsured Americans, and it promises that the federal government will pick up the full cost until 2016 and most of it afterward. A U.S. Supreme Court's decision in June said states could refuse to expand their programs, which provide health coverage for the poor, the disabled and elderly.
Many Kansas Republicans are skeptical of the funding promises, noting the federal government's ongoing budget problems. Officials assume Brownback will declare after the election whether Kansas will opt in or out of the expansion, but retiring House Speaker Mike O'Neal, a conservative Hutchinson Republican who's also chief executive officer of the powerful Kansas Chamber of Commerce, said last week that voters need to know whether legislators and candidates would support an expansion.
The chamber already has attacked Democrats for opposing a proposed health care "freedom" provision for the state constitution, protesting the federal law's mandate that most Americans buy health insurance starting in 2014. O'Neal issued his statements as Democrats were pointing out that the measure was largely symbolic, countering the chamber's assertions in mailings that the proposal would "stop the Obama agenda at the Kansas border."
But the Medicaid issue also ties into long-standing Republican themes portraying Democrats as advocates of big government. A report in July from the nonpartisan Kaiser Family Foundation said an expansion would cover nearly 264,000 adults in Kansas — where 393,000 residents now receive health coverage through the state.
"The simple fact is, we can't afford it," said House Majority Leader Arlen Siegfreid, a conservative Olathe Republican, adding that if Obama is re-elected, "We're going to be watching that very closely."
Democrats aren't openly embracing a Medicaid expansion, even if they believe it would reduce the number of uninsured Kansans. They contend the state can't seriously contemplate any additional spending because of massive income tax cuts enacted this year.
Kansas Democratic Party Chairwoman Joan Wagnon said any discussion of expanding Medicaid was "rendered moot" when Brownback signed the tax cuts in May. Legislative researchers estimate that the cuts are worth $4.5 billion over the next six years and project that the reductions — meant to stimulate the economy — will produce collective budget shortfalls approaching $2.5 billion during the same period.
"He's dug a hole as big as the Grand Canyon in the budget," Wagnon said.