The Mini-Debate About Expanding Medicaid Had A Tragic Ending

By C.J. Janvoy, Kansas Reflector

March 5, 2021

So here’s where we are, Kansas: There’s an issue most of you — a healthy majority! — agree on, but no hope of legitimate, respectful consideration from your representatives in Topeka.

The people who control the conversation won’t give this popular idea a real chance to be heard. So the ones who are trying to deliver on it threw a sad Hail Mary party on Wednesday.

Members of the Kansas Senate were in the midst of coming to nearly full agreement on an uncontroversial bill to increase funding for community mental health centers. God knows Kansas needs all the mental health help it can get right now.

Before they could take that vote, however, Senate Minority Leader Dinah Sykes, a Democrat from Lenexa, offered a dramatic amendment: She proposed adding Medicaid expansion to the community mental health center bill.

Before we get to the hopelessness of what happened next, let’s review what Kansans think about expanding Medicaid. According to the political scientists at Fort Hays State University, 63.5% of you support it. Slightly more of you, 64%, agree that your fellow Kansans who are able to get health insurance from expanded Medicaid “deserve” this benefit from the state. And 71.8% of you agree that expanding Medicaid would help rural Kansas hospitals stay open.

Those are large-hearted Kansans talking in those numbers, people who understand that the money the federal government will kick in to help pay for Medicaid expansion is our money coming back to us, and they’re perfectly fine spending it to help tens of thousands of their friends, neighbors and family members get access to health care.

By contrast, let’s listen to one of the first points made by Sen. Richard Hilderbrand, a Republican from Galena, when he rose in opposition to Sykes’ amendment: “If you pass Medicaid expansion, you’re voting for taxpayer funded abortions in Kansas.”

Having dropped the A-bomb that decimates all rational debate about everything in Kansas, Hildebrand embarked on a 17-minute soliloquy that serves as testament to the dysfunctional discourse in the Kansas Legislature.

Hilderbrand had questions about the actual number of people who might get this “free insurance.” There was also the national debt, and Hilderbrand expounded on a point made by his colleague, the freshman Republican Sen. Beverly Gossage, of Eudora, who had expressed concern about adding to the national debt by covering more “able bodied adults.”

“Just for giggles,” Hilderbrand said — no one was laughing — he’d pulled up the national debt clock. When Gossage had begun talking, he said, the clock was at $28,006,681,009,167; in the 25 minutes since then, it had gone up several hundred thousand dollars.

“It reminds me when I go to the gas station and I’m pumping gas in my car, watching the dial go like that,” he said. “It just keeps going. For every single person in America, we owe — and this is even for our grandkids that are not born yet, our kids that aren’t born, our great grandkids — $84,834 before they step one foot into this good country of America.”

Is this really a good country, though, when we’re OK with watching others struggle to get basic health care?

Hilderbrand went on, exploring his lack of belief in trickle-down economics, his mother’s trouble finding a Medicare provider, increases in insurance premiums, profit margins for the University of Kansas Hospital System — “I apologize, went down a little bit of a rabbit hole,” he said, before burrowing into to the next one, which was (I think) about what happens “if you expand it to able bodied people, young males that do not have any children,” the next time the state faces budget cuts.

Others spoke over the course of an hour (the conversation starts at about 1:35 in the YouTube video), before Sykes’ amendment met the end we all knew was coming anyway. There will be no rational debate about Medicare expansion in Kansas, but there will, at least, be a record of the 23 Republican senators who voted against it come re-election time.

One of those was Sen. Carolyn McGinn of Sedgwick, who sounded almost pained as she made a point of explaining her “no” vote. She wanted to be able to debate Medicaid expansion on its own merits, not as an amendment that might interfere with the bill to get mental health help to community clinics.

What I’d heard in her voice, she told me later, was frustration.

“It was frustration on both sides,” she said. “Frustration that we haven’t had a chance to debate the bill on the floor, and every year the other side has to just pull out this amendment. There’s never any preparation for us, and it’s huge legislation that needs preparation and facts.”

McGinn told me her constituents are “pretty split” over the issue. “It’s a mix,” she said.

A floor debate would help her figure out what’s best for the Kansans in her district, but there’s no hope of having that discussion this session.

“We had a better chance last year,” McGinn told me, referring to the just-before-COVID days when Democratic Gov. Laura Kelly had worked out an agreement with Republican Jim Denning, then Senate Majority Leader.

That, too, was derailed by abortion politics.

This year, a majority of Kansans aren’t getting the respect of a true debate because Republican leaders are afraid that might lead to a Democratic governor’s policy victory.

Is it any surprise so many Kansans need mental health help?