TOPEKA, Kan. — Kansas won't be extending its health coverage to thousands of poor adults under former President Barack Obama's signature health care law after Democrats and moderate Republicans failed Monday to override conservative GOP Gov. Sam Brownback's veto of an expansion bill.
The state House voted 81-44 to override Brownback's veto of the measure , which would have expanded the state's Medicaid program to cover as many as 180,000 additional adults. But supporters needed three more votes, or 84 in the 125-member chamber, for the two-thirds majority necessary to overturn the governor's action.
Brownback has been a vocal critic of the Affordable Care Act, also known as "Obamacare." The governor argued in his veto message that expanding Medicaid would burden the state with "unrestrainable" costs even though the 2010 national law promised that the U.S. government would pick up most of the cost.
President Donald Trump wants to repeal Obama's health care law, but an effort in the U.S. House collapsed last month, encouraging officials in Kansas and other states to pursue expansions. Yet some Republicans in Kansas still contend that national health policy is too unsettled.
Supporters said expanding Medicaid would benefit adults who can't afford to buy health coverage and help struggling rural hospitals remain open. While some lawmakers said they could try to pass a revised expansion plan before the GOP-controlled Legislature adjourns later this spring, others were skeptical.
"I would love to have another go at it, but, honestly, I'm not sure that we're going to make any real inroads until we have different people sitting in some of these seats," said freshman state Rep. Patsy Terrell, a Democrat from central Kansas.
A few rural Republicans whose support could have led lawmakers to override the veto questioned whether their struggling hospitals would have seen as much benefit from an expansion as urban areas. They also worried that extra costs associated with an expansion would hinder efforts to close projected state budget shortfalls totalling more than $1 billion through June 2019.
"One of the ways we got into this problem in the first place is not taking care of our balance sheet," said Rep. Shannon Francis, a western Kansas Republican. "I'm in favour of this if it's not going to adversely affect other services."
Thirty-one states have expanded their Medicaid programs under the Affordable Care Act, including some with Republican governors.
In Kansas, Brownback previously could count on fellow GOP conservatives who opposed Obama's policies to block an expansion. But voters last year turned on him and elected more Democrats and moderate Republicans to the Legislature, forcing a debate.
The Kansas Hospital Association believes an expansion could keep several dozen rural hospitals open. Kansas' Medicaid program covers about 377,000 poor, disabled and elderly residents, but poor adults under 65 who aren't disabled and don't have children aren't eligible.
Brownback and other critics argued that expanding Medicaid would have shifted the state's priority from helping vulnerable, disabled residents to providing health coverage for "able-bodied" adults. Some said if state dollars were pinched, Kansas would be forced to cut in-home services for the disabled, such as help with chores and bathing.
"We don't have the money to expand," said Rep. Brenda Landwehr, a conservative Wichita Republican.
Supporters said an expansion wouldn't shift funds away from services for the disabled. They also relied on projections from the Kansas Hospital Association saying extra federal dollars would ripple through the economy and result in a net plus for the budget.
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John Hanna, The Associated Press