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Top Kansas Republicans knock US Supreme Court health care ruling but don't expect state action


TOPEKA, Kansas — Top Kansas Republicans criticized a U.S. Supreme Court ruling validating a key part of the federal health care overhaul, although one said Thursday that the decision reduces pressure on the Legislature to expand the state's Medicaid health program for the poor.

The high court's majority allowed insurance subsidies for consumers buying coverage through an online federal marketplace in 34 states including Kansas that refused to set one up. Republicans in Kansas contend the 2010 law championed by Democratic President is imposing burdensome mandates, driving up health insurance costs and hurting the economy.

GOP officials said they are disappointed with the Supreme Court decision because they read the federal law as allowing subsidies only in states with their own exchanges. GOP Gov. Sam Brownback's spokeswoman, Eileen Hawley, said in an email statement that the decision "blatantly ignores the language of the law."

But Kansas Senate Majority Leader Terry Bruce said he had worried that ending subsidies would push legislators toward expanding the state Medicaid program providing coverage for the needy and disabled to also help thousands of residents who could no longer afford private insurance.

"The relief valve was triggered by the court's ruling, as unique as it was," said Bruce, a Nickerson Republican.

The Kaiser Family Foundation estimates that about 70,000 Kansas consumers were receiving subsidies averaging $231 a month under the federal Affordable Care Act. The Kansas Association for the Medically Underserved issued a statement calling the Supreme Court ruling "a huge victory for consumers."

"This decision affirms what we have already known — the ACA works, allowing many Kansans to finally have access to affordable health care insurance," said Denise Cyzman, the group's executive director.

Three members of Kansas' all-GOP congressional delegation pledged to keep fighting to repeal the law, Sen. and Reps. and .

But Bruce and state Rep. Dan Hawkins, chairman of the House Health and Human Services Committee, said they don't see a need for action by the Legislature.

Even with subsidies, hospitals, other health care providers and advocacy groups are pushing lawmakers to expand Medicaid to cover as many as 130,000 adults who aren't eligible for the federal assistance. Republican legislators are skeptical of the federal government's promise to pay most of the cost, and many don't want Kansas taking a step that the federal overhaul encourages.

"Right now, there's not a whole lot of support," Wichita Republican Hawkins said of expansion.

Hawley said Thursday that Brownback's position on an expansion remains the same. She said he believes the state must first ensure that Medicaid fully covers in-home services for the disabled and then show that an expansion can be sustained financially, long-term. She also said he wants the federal government to allow a work requirement for Medicaid participants.


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