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Medicaid expansion issue in Kan. legislative races

Associated Press Modified: November 4, 2012 at 11:45 am •  Published: November 4, 2012
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Republicans enter the election with majorities of 32-8 in the Senate and 92-33. However, the Senate's leaders have been GOP moderates, and they've worked with even liberal Democrats since Brownback took office in January 2011 to stall some of the conservative governor's agenda. Conservatives ousted eight moderate GOP senators in the August primary, making it possible for the GOP right to control both chambers, particularly if Republicans retain or expand their majorities.

Democrats have positioned themselves as the last check on Brownback's agenda. The chamber and other Brownback allies have made Obama a key issue — a tactic that worked well both in 2010 and this year's primaries.

Brownback has been critical of the federal health care overhaul, and he faces key decisions about whether the state will expand Medicaid and have a role in an online health insurance marketplace contemplated by the law.

He acknowledged he's worried about the potential cost of expanding Medicaid but said, "We're not going to be doing anything prior to the election."

The federal health care law says that in 2017, states would pick up 5 percent of the cost of the Medicaid expansion, with the figure growing to 10 percent by 2020. In the past, states generally have been required to pick up about 40 percent of the cost, and in Kansas, the state's share for its $2.9 billion-a-year program is almost $1.2 billion.

Some state officials also worry that Kansas could face substantial new costs if it agrees to the Medicaid expansion because people who are now eligible without the expansion but not participating in the program also could seek coverage, an issue noted by a Congressional Budget Office report in July.

Joshua Powell, a part-owner of small web-design and media businesses who's running for the Kansas House in a north Topeka district as a conservative Republican, said the federal health care law is unpopular because people "just don't want Washington messing with their health care." He said voters aren't focusing on the Medicaid expansion, but he's wary.

"Does the federal government have the money for it?" he said. "I mean, we're running pretty big deficits right now."

Powell's opponent, Democratic state Rep. Sean Gatewood, is alternately frustrated and semi-amused by attempts to tie him to Obama, someone he's not met. Gatewood said he'd place a higher priority on eliminating the state's waiting lists for disabled residents seeking in-home services than expanding Medicaid, but he sees neither as possible because of the income tax cuts.

"It's all irrelevant," Gatewood said.

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