The 2020 Kansas legislative session will begin on January 13, 2020. During the 2019 session more than 100 bills addressing Medicaid expansion, KanCare, controlled substances, scope of practice for providers, child welfare, insurance, firearms, and taxes on food were introduced. Because 2019 was the first year in a legislative biennium, or two-year cycle, all bills that were still under consideration when the Legislature adjourned in May 2019 are available for consideration in 2020.
Medicaid expansion will likely be on the table early in the session. After an expansion bill similar to one introduced by Gov. Laura Kelly in 2019 passed the House late in the session but did not receive a hearing in the Senate, the Governor’s Council on Medicaid Expansion began meeting in September to study expansion models in other states. Two interim committees also met this fall to review and discuss a Senate proposal for expansion that would differ significantly from the version that passed the House.
Other health-related issues that may be considered by legislators include medical marijuana, the availability of resources to address the behavioral health needs of Kansans, the cost of health care, private health insurance premiums and coverage options, and licensure/scope of practice for some types of providers.
Legislators likely will have multiple Medicaid expansion proposals to consider early in the 2020 session.
Gov. Kelly, who has repeatedly stated that expansion is one of her top priorities, announced the creation of the Governor’s Council on Medicaid Expansion on September 4, 2019. The council, which includes legislators and individuals representing health care providers, health foundations, health advocates and managed care organizations, was charged with “supporting legislative efforts to find the best version of Medicaid expansion for Kansas” and was asked to study the costs and benefits of models in other states that have expanded Medicaid for adults age 19-64 with income up to 138 percent of the federal poverty level (FPL). The council met three times during 2019 and will be submitting a recommendation to the governor in support of expansion, along with suggestions that the state maintain as much policy authority as possible over the program and establish a system for evaluating the costs and operation of the program.
Although the House passed an expansion bill late in the 2019 session — House Bill (HB) 2066, which was similar to bills introduced by the governor — it received no vote in the Senate. At the end of the session Senate Majority Leader Jim Denning and other Republicans announced they would work on an expansion bill during the interim session that would be ready for debate early in the 2020 session. Two interim committees — the Senate Select Committee on Healthcare Access, chaired by Sen. Gene Suellentrop, and the Special Committee on Medicaid Expansion, chaired by Rep. Brenda Landwehr — met during October and November to receive testimony and study an expansion proposal crafted by Sen. Denning that could serve as the Senate proposal.
During the meeting of the Senate Select Committee on Healthcare Access on October 23 and 24, members reviewed and revised a bill draft based on the proposal presented by Sen. Denning. At the conclusion of the meeting the committee requested that a copy of the revised bill draft and two memorandums — one comparing it to HB 2066, the bill passed by the House during the last session, and another comparing it to Senate Bill (SB) 54, a straightforward expansion bill introduced in the Senate last year — be delivered to the Special Committee on Medicaid Expansion. The revised bill draft, which would require the approval of a Section 1115 waiver application by the Centers for Medicare and Medicaid Services (CMS), proposes the state present three options for expansion in the following order for federal approval:
- First, for adults age 19-64 with income up to 100 percent of FPL
- If that is not approved, then for adults age 19-64 with income up to 100 percent of FPL, with the option of Medicaid coverage or a marketplace plan offered to those with income from 100 percent of FPL up to 138 percent of FPL
- If neither of those options are approved, then expansion for all adults age 19-64 with income up to 138 percent of FPL.
The draft bill revised by the Senate Select Committee also calls for the state to seek a Section 1332 innovation waiver to stabilize the private individual health insurance market by implementing a reinsurance program.
Following receipt of the report from the Senate Select Committee, the Special Committee on Medicaid Expansion elected not to forward or recommend any specific expansion bill but did include the draft bill revised by the Senate Select Committee as reference material supporting its recommendations, which focused primarily on gathering additional information related to expansion from conferees or requesting information to respond to questions raised during committee discussions.
Gov. Kelly has said Medicaid expansion and reinsurance for the private individual health insurance market are separate issues and do not need to be combined, as they are in the bill draft that emerged from the Senate Select Committee. On November 21, Senate Minority Leader Anthony Hensley released the minority response to the Senate Select Committee report. Both Sen. Hensley and House Minority Leader Tom Sawyer have stated they believe the revised bill draft is more complicated and expensive than HB 2066 and will delay implementation of expansion. On December 3, Sen. Hensley pre-filed SB 246, a bill that is similar to HB 2066, as passed by the House.