KHI News Service

House speaker talks about Medicaid expansion, reading initiative, autism mandate

By Dave Ranney | March 22, 2013

House leaders today expressed support for a Senate budget provision that would bar expansion of the state's Medicaid program without the Legislature's OK.

KHI News Service

House Speaker Ray Merrick, left, and House tax committee chair Rep. Richard Carlson at one of the speaker's weekly press conferences.

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House Speaker Ray Merrick, a Stillwell Republican, said he sided with language added to the Senate budget bill Thursday that would bar state agencies from spending any money to expand eligibility for the Kansas Medicaid program without the expressed consent of the Legislature.

He said he didn’t think the amendment introduced by Sen. Dennis Pyle, a Hiawatha Republican, was “inconsistent with I’ve been saying the whole time through.”

Merrick's remarks came in response to questions during a press conference in his Statehouse office that also included House Appropriations Chair Marc Rhoades, a Newton Republican, and Rep. Richard Carlson, the St. Marys' Republican who heads the House tax committee.

Rhoades said he also opposed expanding the state's Medicaid program and that he hoped the federal government would see fit to convert Medicaid to a block- grant program that would allow states to “be creative” in controlling health care costs.

“This carrot-and- stick thing - I just get really tired of that,” he said, referring to the federal government's pledge to cover 100 percent of the costs for newly eligible Medicaid enrollees for three years in the states that choose to expand their programs in accordance with guidelines of the federal Affordable Care Act. “Until we have some arrangement with the federal government on the ‘stick’ part, I’m not really in favor of taking the carrot.”

The federal government currently covers almost 60 percent of Medicaid costs in Kansas, with the state picking up the balance.

Rhoades and other House Republicans have said the doubt the state can meet its pledge to cover the full Medicaid costs given federal fiscal problems. They've also said they don't think the state can afford the additional costs of covering people already eligible for the program expected to enroll once the Affordable Care Act's coverage mandates begin in January.

Third-grade reading

Merrick said he favored a Senate measure that would allow parents of third graders to have the final say in whether their children would be allowed to advance to the fourth grade after failing to pass a reading test.

The amendment was added to a bill passed by the Senate Education Committee on Thursday.

Gov. Sam Brownback has expressed strong support for not passing third graders who fail to pass a reading test.

Merrick said he would defend a parent’s right to decide whether their child was advanced from one grade to another.

But he also said parents who would resist holding their children back a grade after being made aware of their reading deficiencies were “part of the problem.”

“I think they’re doing a disservice to their child," he said, "but as far as I’m concerned that’s still their right.”

Autism coverage

Merrick said he doubted that House Bill 2395, which would require health insurers to cover autism, would pass this year.

“I’ve told the insurance people to bring me a solution,” he said, referring to the autism-coverage bill. “There are solutions. Thirty-one states out there have a solution. What’s the right solution for Kansas?”

Merrick said he would like to see a compromise between the state’s insurance lobby, which opposes the mandate, and the families of autistic children who want the condition covered.

“I want a global solution to the problem,” he said.

But he said he doubted a compromise would be reached during this year’s legislative session, "unless something moves really fast between now and when we get out."

Earlier this week, several parents of autistic children criticized Merrick during a hearing before the House Insurance Committee, accusing him of bowing to pressure from the insurance lobby, which has argued that the mandate would drive up the cost of insurance premiums.

The Kansas Association of Health Plans and The Kansas Chamber submitted testimony opposing the bill.

Merrick said he remained committed to doing “what’s right,” adding that nothing the Legislature accomplishes “is fast enough for most people.”

Michael Wasmer, associate director of state government affairs for the advocacy group Autism Speaks, predicted efforts at compromise with the insurance industry would be a waste of time.

“If the insurance companies were willing to do this for all the right reasons, they would have done it four years ago. That’s how long this has been before the Legislature,” Wasmer said. “But they’re not willing to do it, which is why there needs to be a mandate.”

Wasmer said a state-sanctioned pilot project last year found that requiring Kansas health insurers to cover autism would increase premium 31 cents per person per month.

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