2025 Kansas Legislative Preview

Introduction

The 2025 Kansas legislative session will begin on Monday, Jan 13. Because 2025 is the first year in the legislative biennium, or two-year cycle, none of the more than 60 unfinished health-related bills from last session remain on the calendar.

The 2024 general election included races for all 125 House seats and 40 Senate seats. As a result of the election, there will be 23 new House members and eight new Senate members in 2025. Republicans continue to hold supermajorities in both chambers with 88 Republicans and 37 Democrats in the House, and 31 Republicans and 9 Democrats in the Senate.

Legislators and other stakeholders were busy throughout the summer and fall with 30 interim committees — including seven committees specifically focused on health-related issues — meeting during August through mid-December. Medical marijuana is expected to once again be on the table early in the session after members of the Special Committee on Medical Marijuana met for two days during October and received more than 100 pieces of testimony. Legislators also may consider recommendations or topics discussed by other interim committees related to child welfare, oral health and targeted case management. In addition, the 2025 Legislature will be implementing a new process for development of the fiscal year 2026 budget bill. Work on this new process began prior to the start of the session by the newly formed Special Committee on Legislative Budget that began meeting in November.

Figure 1. 2025 Kansas Legislative Makeup

KanCare

During the 2025 session, legislators likely will review the work of several Medicaid-related interim committees, including the Special Committee on Sedation Dentistry, the Special Committee on Targeted Case Management and the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight (Bethell Joint Committee). Each of these committees focused on improving access to services and identified challenges within Kansas’ Medicaid program and related services that could be addressed with legislative action.

Special Committee on Sedation Dentistry

The Special Committee on Sedation Dentistry, which met in October, was charged with exploring ways to improve access to sedation dentistry services for Medicaid beneficiaries, particularly in rural areas. Testimony revealed significant gaps in provider availability, with many counties lacking practitioners capable of performing sedation dentistry. While some federally qualified health centers (FQHCs) and Indian Health Centers offer these services, the overall availability remains limited, forcing patients in underserved areas to travel long distances for care. Committee members also heard from the Kansas Department of Health and Environment (KDHE), providers and advocacy organizations about the challenges providers face in delivering sedation services, particularly for pediatric and special needs populations, and underscored the disparities in reimbursement rates between Kansas and neighboring states.

Kansas Medicaid reimbursement rates for sedation dentistry were found to be lower than those in neighboring states, including Missouri, which further contributes to the challenges of recruiting and retaining providers. The Special Committee reviewed data comparing state reimbursement rates and discussed potential increases to align Kansas rates more closely with those of neighboring states. Special Committee members also discussed additional billing codes, such as those for behavioral health management and dental case management, to support individuals with complex medical and dental needs. They also discussed the need for administrative reforms, such as simplifying the current time-based billing model for sedation services. The goal of these measures would be to reduce barriers to provider participation and improve access to essential dental care for individuals with intellectual and developmental disabilities.

Special Committee on Targeted Case Management

The Special Committee on Targeted Case Management, which also met in October, reviewed Kansas’s compliance with federal conflict-free case management requirements under the Home and Community-Based Services (HCBS) regulations. These rules require that case management functions be separated from service delivery to ensure participant choice and reduce conflicts of interest.

The Special Committee examined how Kansas could better meet federal compliance standards while ensuring high-quality, participant-centered planning and heard testimony that highlighted the risks of conflicts of interest when case managers are employed by agencies that also provide direct services, which can influence service plans in ways that prioritize agency convenience over participant needs. Recommendations from conferees included strengthening procedural safeguards, enhancing training for case managers and ensuring transparency in service planning processes. Special Committee members also discussed the importance of maintaining freedom of choice for participants when selecting service providers, as required under federal guidelines.

Bethell Joint Committee

The Bethell Joint Committee reviewed several key issues, including the new managed care organization (MCO) contracts that went into effect on Jan. 1, reimbursement rates and service expansions. Committee members discussed ongoing challenges with provider reimbursement rates and claims processing and heard testimony highlighting significant delays in claims reconsideration, while conferees noted that these delays impact providers’ financial stability and their willingness to participate in the Medicaid program. Committee members also discussed the need to streamline billing processes and establish safeguards to ensure a seamless transition to the new MCO contracts.

The Committee also reviewed updates on the Medicaid-funded doula program. The Kansas Department of Health and Environment reported that while utilization of the program has been low and few doulas have elected to accept Medicaid, initial data suggests that doula services are an effective practice that enhance maternal outcomes for Medicaid beneficiaries. Committee members recommended ongoing monitoring of the program’s fiscal impact and effectiveness. Other topics discussed by the Joint Committee included targeted reimbursement rate increases for services such as Applied Behavior Analysis therapy for children with autism and expanded pediatric dental services.

Medicaid Expansion

To date, 40 states and Washington, D.C., have adopted the Affordable Care Act (ACA) provision to expand Medicaid coverage to adults with income through 138 percent of the federal poverty level ($43,056 for a family of four in 2024) and 10 states, including Kansas, have not adopted expansion.

During the 2024 legislative session, two companion bills to expand Medicaid effective Jan. 1, 2025, were introduced in the House and Senate early in the session. The bills included a work requirement with some exemptions and included provisions intended to cover the state’s 10-percent share of the cost to expand Medicaid, including estimated increased drug rebates, a hospital fee and savings from higher reimbursement rates for existing Medicaid recipients. The House Health and Human Services Committee held a hearing on the House bill but took no vote, and the Senate Ways and Means and Public Health and Welfare Committees held only a joint informational hearing on the Senate bill. An estimated 151,898 Kansans, including 106,450 adults and 45,448 children, may have been newly enrolled in KanCare if Medicaid had been expanded beginning in 2025.

In 2025, Kansas lawmakers may pay close attention to actions taken by President-elect Donald Trump that may impact Medicaid expansion and KanCare. In his previous administration, he supported efforts to repeal and replace the ACA, including Medicaid expansion, though these attempts were ultimately unsuccessful. The previous Trump administration also proposed significant changes to Medicaid financing, including block grants or per capita caps that would limit federal contributions and shift more responsibility and authority to the states. Additionally, his administration approved waivers that imposed work requirements, the payment of premiums and other requirements as conditions for Medicaid eligibility.

Figure 2. Status of State Medicaid Expansion

Behavioral Health

Discussions and recommendations of the Bethell Joint Committee, which met in August and October, also could be the basis for new behavioral health initiatives and legislation during the 2025 session, with a focus on improving access to behavioral health services, addressing workforce shortages and enhancing integration within the state’s managed care system.

During its meetings, the Committee reviewed behavioral health needs in nursing facilities, specifically for the growing population of residents with dementia and behavioral health conditions such as psychosis and bipolar disorder. Testimony presented during the meetings highlighted the need for targeted programs to meet these complex needs, including value-based reimbursement models that provide additional financial support for nursing facilities offering behavioral health services and training for staff to manage behavioral health challenges.

Workforce challenges were also a central theme, with discussions focusing on the severe shortage of behavioral health professionals across the state, including psychiatrists, social workers and peer support specialists. Testimony highlighted the importance of workforce recruitment and retention strategies, such as loan forgiveness programs and competitive reimbursement rates for behavioral health providers.

The Committee also discussed opportunities to expand access to community-based services, particularly in rural areas. Integration of a community service coordination program into managed care contracts was discussed, which would be designed to offer additional support for individuals to access local resources and is projected to be implemented in the second quarter of next fiscal year. Testimony also emphasized the importance of behavioral health crisis intervention programs, including mobile crisis response teams and crisis stabilization units. Efforts to enhance behavioral health services for children and adolescents were discussed, including school-based behavioral health programs and early intervention strategies aimed at addressing mental health needs before they escalate. Data collection and transparency in program performance were emphasized by presenters as essential components for improving outcomes and allocating resources effectively.

Senate Leadership: 31 Republicans, 9 Democrats | Majority – Republicans

Medical Marijuana

Legislators may again return to medical marijuana and cannabis-related legislation in 2025. During the interim period, the Special Committee on Medical Marijuana heard testimony addressing public health implications, federal rescheduling efforts and challenges in aligning state and federal regulations. Thirty-eight states, three territories and the District of Columbia allow the medical use of cannabis products.
Committee members heard testimony related to concerns from law enforcement about the expansion of black markets, risks associated with high-potency THC products and regulatory gaps for hemp-derived cannabinoids like Delta-8 THC. Proponents emphasized potential benefits for patients with chronic conditions, while opponents questioned its medical efficacy without FDA approval and raised addiction concerns.
As the discussion continues, Kansas legislators may need to weigh health, safety and economic impacts, consider frameworks to regulate medical marijuana and address emerging issues such as federal banking restrictions and product safety.

Figure 3. Status of State Marijuana Legalization Decisions

Child Welfare

Legislators also will maintain their focus on critical issues within the state’s child welfare system in 2025 and may consider potential legislation to address ongoing challenges. During meetings of the Joint Committee on Child Welfare System Oversight throughout 2024, legislators heard updates from state agencies, providers, advocates, parents and other Kansans regarding placement stability, mental health service shortages, workforce challenges and inter-agency communication.

The Committee heard extensive testimony, including updates on the McIntyre v. Howard lawsuit settlement, which outlines key goals such as reducing short-term and night-to-night placements, improving placement stability and increasing access to timely mental health services for children in foster care. While some progress toward these goals has been made, testimony highlighted persistent gaps, particularly in serving children with complex needs. Public testimony further raised concerns about barriers families face in accessing medical and educational services for children, insufficient information provided to foster and kinship placements, and the negative impacts of workforce shortages and high staff turnover on communication, case continuity and timely reunification efforts.
Key recommendations from the Committee include improving oversight of foster care contractors to ensure accountability, modernizing data-sharing systems for better coordination among agencies and addressing workforce shortages through increased compensation, expanded training opportunities and reduced caseloads. Additional suggestions emphasized the need to recruit and retain foster families, particularly in rural and underserved areas, expand therapeutic foster care options and provide stronger support for kinship placements. Discussions also stressed the importance of upstream prevention services, which aim to reduce the number of children entering foster care, and highlighted the need for greater collaboration among stakeholders to achieve better outcomes for children and families.

In July, Rep. Susan Concannon, chair of the Joint Committee, co-chaired a policy workshop for Midwest legislators hosted by the Council of State Governments, which included sessions on improving child welfare system data, identifying the core components of a well-functioning system and insights about best practices in other states. She then initiated the work of the “Kansas Child Welfare, Reimagined” working group, which met from October through December. The working group, which included legislators, members of the Kansas judicial system, child welfare advocates and other key stakeholders, met weekly to explore potential reforms and best practices and generate specific recommendations for improving the state’s child welfare system. The work of both the Joint Committee and the working group is expected to be the basis for legislative priorities for the 2025 session, with legislators focused on redefining when and how children enter the foster care system, improving placement stability, addressing workforce capacity and quality, expanding mental health service access and fostering more effective collaboration across state agencies, contractors and other child welfare entities.

House Leadership: 88 Republicans, 37 Democrats | Majority – Republicans

Homelessness

During the 2024 legislative session, homelessness was a topic of discussion in the House Welfare Reform Committee and Senate Ways and Means Committee, and two companion bills, House Bill 2723 and Senate Bill 542, related to funding for homeless shelters were considered. Both bills would have provided funding for a grant program to fund homeless shelter infrastructure that would have awarded funds to local governments for the building or improvement of congregate and non-congregate shelters to provide services for individuals and families without housing and persons at risk of being without housing. The bills also included a requirement that local governments enforce local ordinances regarding camping and vagrancy as a condition of eligibility for the program.

Early in the 2024 session, Welfare Reform Committee Chair Francis Awerkamp reported that the U.S. Supreme Court was expected to issue an opinion in the case of Johnson v. City of Grants Pass (Oregon), which dealt with the constitutionality of anti-camping and park exclusion ordinances passed by the city. He also noted that the outcome of the case might provide some clarity regarding what steps cities may take to address homelessness. At that time Kansas Department for Aging and Disability Services (KDADS) Deputy Secretary Andy Brown also reported that Kansas was ranked 16th highest per capita in the U.S. for the percentage of homeless individuals without shelter, with a significant number residing in Kansas City, Lawrence, Topeka and Wichita, due to the scarcity of affordable housing and inadequate support services.

In March, the Welfare Reform Committee held a hearing on HB 2723, but the bill died in committee. Later in March, the Ways and Means Committee held a hearing on SB 542, amended the bill to provide $20 million of State General Funds over two years for the grant program and included a requirement that all cities and counties adopt an ordinance or resolution prohibiting unauthorized public camping, sleeping or obstruction of sidewalks. The bill also would have prohibited cities or counties from dropping off homeless individuals outside such city or county’s jurisdiction without consent of the receiving entity. The bill was passed favorably out of committee as amended but died on the Senate calendar.

On Dec. 27, 2024, the federal Department of Housing and Urban Development (HUD) released a national point-in-time report that provides an annual snapshot of the number of people living in shelters, temporary housing and unsheltered settings on a single night in January 2024. The HUD report shows that the total number of people experiencing unsheltered homelessness in Kansas was 2,793, a 6 percent increase from 2023.

On Dec. 17, 2024, the Wichita City Council modified Wichita’s encampment ordinance to give law enforcement the power to remove homeless encampments without the 72-hour notice that has been required in the past. The modified ordinance allows only law enforcement officers to issue citations for illegal camping, but also requires there to be shelter beds available. On Jan. 7, 2025, the Topeka City Council will be considering an update to the city’s camping ordinance, which primarily impacts the homeless population. The update would expand the definition of public infrastructure and clarify the specifications for camping on private property.

On June 28, 2024, the Supreme Court issued its opinion in the Johnson case and held that the city’s penalties for violations of its ordinance related to sleeping in public spaces, including sidewalks, streets and city parks, did not violate the Eighth Amendment’s prohibition on “cruel and unusual punishment.” With the clarity provided by the Johnson case regarding the enforcement of anti-public camping and sleeping ordinances, legislators may take a second look at bills similar to those considered in 2024.

Figure 4. Fiscal Year 2025 Approved Expenditures from the State General Fund (in Millions)

Budget

On Nov. 22, the Kansas Legislative Research Department (KLRD) and the Division of the Budget released a memo regarding the State General Fund (SGF) Revenue Estimates for fiscal year (FY) 2025 and FY 2026. The memo showed for FY 2025 a revised estimate of $9.7 billion, a decrease of $59.8 million below the adjusted June 2024 estimate, and for FY 2026 an initial estimate of $9.8 billion. During its Nov. 8, 2024, meeting, the Consensus Group, which includes the Division of the Budget, the Kansas Department for Children and Families (DCF), KDHE, KDADS and KLRD, revised the estimates for all human service consensus caseloads for FY 2025 to $5.5 billion from all funding sources, including $1.7 billion SGF, an all funds increase of $100.3 million, including an SGF decrease of $22.7 million, compared to the budget approved by the 2024 Legislature. The revised estimate for FY 2026 is $5.7 billion from all funding sources, including $1.8 billion SGF, an all funds increase of $199.1 million, including an increase of $72.0 million SGF, above the FY 2025 revised estimate.

For the 2025 session the newly created Special Committee on Legislative Budget, which met in November and December, will be taking the lead on building a fiscal year 2026 budget bill that will be introduced at the start of the session. Historically, the budget committees in both chambers have developed the budget using Gov. Laura Kelly’s proposed budget, which is released after the session begins.