Kansas Reflector

TOPEKA — Several Republican lawmakers have sworn against expanding state health care coverage, arguing that they are “laser-focused” on fixing long wait times for thousands of the state’s disabled residents in need of health care first.

The same lawmakers now say they will not fund more than a small fraction of state-funded waivers for disabilities services each year — an amount that represents the most amount of funding the waitlists have gotten in years, but a figure that won’t keep the lists from growing, let alone providing more Kansans relief.

“Our work is not done,” said House Speaker Dan Hawkins, a Wichita Republican, in an announcement of funding. “We’ll continue to work as quickly and aggressively as possible until the waitlist is eliminated and the intellectual and developmental disability community is equipped with these critical services.”

The Kansas House of Representatives approved funding for the Republican- led plan to fund new 500 slots for the intellectually/ developmentally disabled waitlist and physical disability waitlists through a $34.6 million allocation in the state budget.

If enrollment trends continue along the same lines as last year, when 561 new people enrolled in the intellectual disability wait list, the allocation wouldn’t be enough to stop the lists from growing. The Kansas Council on Developmental Disabilities’ recommendation is to reduce the waitlists by 20% in fiscal year 2025 by funding 1,100 slots on the I/DD waiver and 500 slots on the PD waiver.

The wait list for intellectual and developmental disabilities services is at 5,279 people, according to the most recently available data. The physical disability wait list is around 2,382 Kansans. Wait times can last more than 10 years, and more and more Kansans have been added to the slow-moving lists, living for years without crucial care.

During a Wednesday House budget debate, House Minority Leader Vic Miller, a Topeka Democrat, recommended allocating more money from the state’s rainy day fund to pay for an additional 500 slots, bringing the state budget more in line with advocates’ recommendations.

“If this situation does not represent a rainy day, I don’t know what would,” Miller said. “We collectively have done more this year than we have done recently. And for that, whoever has had a hand in that deserves some credit…All I’m saying is it’s still not enough.”

His attempt failed, with several lawmakers arguing that funding more slots wouldn’t work because the state doesn’t have enough service providers. Disability rights advocates refute these claims.

Rocky Nichols, executive director of the Disability Rights Center of Kansas, said the state providers could handle enrolling 1,000 people into services. Nichols also pointed out that more funding would attract more providers into the state. He turned to 2014, when state providers enrolled 1,744 people all at once into services. Nichols said the state has since implemented higher provider rates, leaving the state’s provider network in a much better place.

“We should challenge ourselves,” Nichols said. “We should not take the easy way out. We must challenge ourselves because people are suffering out there. It’s all very doable.”

Rep. Brenda Landwehr, a Wichita Republican, and chairwoman of a House committee that recently shot down a Medicaid expansion bill, said the state needed to fix its broken health care system before expanding services.

Rep. Will Carpenter, an El Dorado Republican and chairman of one of the most influential legislative committees, spoke against Medicaid expansion Wednesday during Landwehr’s committee on the grounds that disabled Kansans, along with other state residents, need to be helped before the state rolls out insurance for “able-bodied adults.”

In an interview with the Reflector afterward, Carpenter said the state needed to build up its provider network before working to take more people off of the lists.

“The last thing I want to do is have people eligible out there that cannot receive the services that they need,” Carpenter said. “That would be just jerking the rug right out from underneath their feet if we increased it beyond what our providers could take care of. …I want to get these folks taken care of, that’s our job. Medicaid expansion is a totally separate issue. We need to take care of these folks before we take on anyone else.”

Medicaid expansion would expand state health insurance coverage for lower-income families. Under the Affordable Care Act, the federal government covers 90% of the extra cost of Medicaid services in exchange for expanding eligibility to those at 138% of the federal poverty rate and below.

Miller said tying Medicaid expansion to the disability waits was a deliberate attempt to confuse the issues. Kansans with disabilities are already eligible for state health insurance. The wait lists are for Medicaid-funded support waivers that cover a variety of needed services, such as in-home care.

“Until we belly up to the bar and appropriate the money that is necessary to reduce the list, it won’t go down,” Miller said in a Reflector interview. “And that has nothing to do with the discussion and debate about expanding Medicaid for an entirely different population.”

RACHEL MIPRO