First abortion, then coronavirus hinder Medicaid expansion push

By Jim McLean | March 31, 2020

Sen. Susan Wagle, of Wichita, has once again led the fight against Medicaid expansion in Kansas.

Kansas News Service

TOPEKA — A bipartisan plan to expand Medicaid coverage in Kansas may go nowhere if the threat of coronavirus shortens the 2020 legislative session. Legislators rushed to pass a budget in March so that they could take an early and longer-than-usual spring break in response to the coronavirus pandemic. Originally, they were scheduled to stay in session through April 3, take a break and return April 27 to wrap up business for the year.

The Medicaid proposal would extend insurance coverage to more than 130,000 low-income Kansans, including thousands of people 60 and up who are too young to qualify for Medicare but make too much money to receive Medicaid under current regulations. AARP, the Silver-Haired Legislature and many other advocates for seniors support expansion, which has been approved by 36 other states. The federal government picks up 90 percent of the cost.

Susan Wagle, the Wichita Republican who is president of the Kansas Senate, used her position to block consideration of the expansion bill. A majority of state senators back the plan, virtually assuring its passage if Wagle allowed a vote. But Wagle, a candidate for the U.S. Senate, insists that the Legislature first put an anti-abortion amendment to the Kansas Constitution up for a statewide vote.

Democratic Gov. Laura Kelly has tried to force Wagle to drop her blockage, insisting the two issues ought to succeed or fail on their own merits.

“It’s time,” Kelly said, “to stop playing games with people’s health.”

The amendment favored by Wagle would essentially overturn a recent Kansas Supreme Court decision that declared access to abortion a “fundamental” right under the state’s Bill of Rights.

Growing Pressure

Pressure has been building for weeks on legislative leaders — mostly Wagle — to negotiate an end to the stalemate.

In March, more than 70 Kansas Catholic nuns signed an open letter urging legislators to move forward on expansion.

“We cannot wait any longer to give Kansans the care they so desperately need,” the nuns said in the letter written under the banner of the Network Lobby for Catholic Social Justice, a national advocacy group for Catholic sisters.

In a column published in the Topeka Capital-Journal the same month, three former presidents of the Kansas Senate — all Republicans — called on Wagle to reverse what they called her “reckless decision.”

Expansion would cover people whose household earnings fall below 138 percent of the federal poverty level — $36,156 for a family of four.

Not Budging

Wagle, a 20-year legislative veteran, is standing firm.

In an interview with the Kansas News Service, Wagle said expansion supporters may have the votes to pass the compromise. But she said they lack the number needed to pry it out of committee and bring it to the floor.

The abortion issue, she said, “trumps Medicaid expansion.”

Several senators who favor expansion are concerned about moving forward without first approving the constitutional amendment, Wagle said.

They’re “worried,” Wagle said, about expanding Medicaid without first ensuring that the state’s ban on taxpayer-funded abortions would remain in force.

Expansion supporters insist that isn’t a valid concern because Kansas law — unlike some other states — allows only those exceptions permitted under federal law. Those exceptions are to save the life of the woman, or if the pregnancy arises from abortion or rape.

Wagle successfully blocked Medicaid expansion during the 2019 legislative session, saying she wanted more time to study the issue but also calling it a “bloated,” “broken” and “failed” system.

The Senate approved the anti-abortion amendment in late January. The following week, the House fell four votes short of the two-thirds majority needed to advance it to a statewide vote.

If Kansas voters don’t ratify the amendment, abortion restrictions already in place could be challenged and “wiped off the books,” Wagle said.

So, she said, “until that amendment passes” there will be no vote on Medicaid expansion.

Abortion is a defining issue for many conservative voters. So some see Wagle’s fight for the constitutional amendment as an effort to boost support for her U.S. Senate bid.

Insisting politics didn’t drive her decision, Wagle acknowledges the standoff illustrates her willingness to fight for conservative causes.

“I’m the proven conservative in the race with a record that voters can trust,” she said.


In the end, it may not matter whether Wagle yields.

Jim Denning, the second-ranking Republican in the Kansas Senate who worked on the Medicaid proposal with Gov. Kelly, said he thinks he can rally enough senators behind a compromise to force a Medicaid expansion vote even over Wagle’s objections. However, that was before coronavirus upended things.

Jim McLean is the senior correspondent for the Kansas News Service, which is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy. You can reach him on Twitter @jmcleanks or email jim (at) kcur (dot) org. The Associated Press also contributed to this report.