Confronted with a $344 million revenue shortfall that must be filled by June 30, Kansas Gov. Sam Brownback has defiantly refused to rethink his massive, budget-busting income tax cuts for businesses and the wealthy. Instead, the Republican is resorting to a spate of other measures: slashing education, raiding the state's highway fund, diminishing pension contributions, and proposing new sales taxes, which disproportionately hit low-income people. Still, these drastic steps won't suffice, a harsh reality that has forced Brownback and his Republican allies in the legislature to contemplate the previously unthinkable: turning to a socialist program, Medicaid, to rescue the state from the disastrous consequences of their right-wing economic experiment.
Some background: While President Obama's signature health care reform law is hardly the socialist monster its critics depict -- it compels most adults to purchase private health insurance plans, and doesn't include a public option, let alone establish a single-payer system -- it did provide for the expansion of Medicaid, a public (i.e., socialist) health insurance program for low-income people jointly funded by the states and the federal government. Under the Affordable Care Act, the federal government pays states for expanding Medicaid to those with incomes up to 138 percent of the federal poverty level -- about $33,000 per year for a family of four. While "socialism" in the abstract doesn't typically poll well in the U.S., the expansion of this particular socialist program is one of the more popular aspects of Obamacare; even in the reliably Republican Deep South, 60 percent of Americans support it.
But most Republican governors oppose Medicaid expansion, and under the Supreme Court's 2012 Obamacare ruling, states have the right to refuse to expand the program. Kansas has exercised that right, to the detriment of its poor residents. But amid the state's fiscal mess, that may soon change, Talking Points Memo's Daniel Strauss reports:
Gov. Sam Brownback (R) and the Republican-controlled legislature in Kansas is inching ever so slowly toward expanding Medicaid under Obamacare. If Kansas did expand Medicaid, it would be the latest in a list of deep-red states—including Arkansas, Utah, and Indiana—to actually take federal dollars through Obamacare, despite having conservative legislatures and fire-breathing, anti-ACA Republican governors.
The chances of Brownback, who is facing an enormous budget deficit, signing into law a bill expanding Medicaid in the state is still far from a sure thing, but it became slightly more likely during some legislative maneuvering last week. Conservative legislators were forced to agree to hold a hearing on expanding Medicaid in exchange for getting state Rep. Jim Ward (D) to drop an amendment to an bill that would have simply expanded Medicaid in the state to 138 percent of the poverty line.
Brownback, who had previously expressed strong opposition to Obamacare, signaled Wednesday he wasn't totally opposed to a Medicaid expansion.
"I haven’t said we’ll take it. I haven’t said we wouldn’t," Brownback said according the Lawrence Journal-World. "Last year, I signed the bill that the Legislature passed [saying] that the Legislature had to approve any Medicaid expansion. I think that’s the way to go because it’s going to involve long-term costs. And the Legislature, that’s their primary authority."
Under a proposal advanced by the Kansas Hospital Association, Strauss reports, Kansas would accept the federal Medicaid funds and scrap a law that prohibits the governor from expanding the program without legislative authorization. Brownback's staff has consulted with the association on the proposal, and legislators will hold hearings on it on a date to be determined.
The developments come three months after Brownback turned to another provision of Obamacare -- a Medicare drug rebate program expanded under the ACA -- to help stanch Kansas' fiscal bleeding. Brownback, a ferocious opponent of the health reform law, borrowed $55 million from the program.
So recovering from Brownback's "real live experiment" in right-wing economics may require Kansas lawmakers to swallow a bitter, socialist pill. If the state's Republicans down it, Kansas can fully focus on the things that really matter -- like instituting anti-LGBT discrimination and cracking down on schoolteachers who assign Toni Morrison books.
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