A bid to force debate on Gov. Laura Kelly's plan for Medicaid expansion Wednesday was blocked on procedural grounds ahead of Kansas Senate votes advancing a bill granting Kansas Farm Bureau the exclusive opportunity to offer a basic health benefit plan not subject to standard medical insurance policies.
Supporters of the legislation contended Farm Bureau could provide health coverage — technically, not insurance — to an estimated 42,000 members of the organization at rates 30 percent lower than premiums of other policies on the market.
Critics argued the bill would enable Farm Bureau to market a plan sidestepping routine state and federal requirements, subject people to substandard medical care and divide families by excluding individuals with pre-existing conditions.
"This plan gives options to people," said Sen. Rob Olson, an Olathe Republican who chairs the Senate's insurance committee. "Give them the service they need. Drive competition to lower insurance in this state. I think this is going to save and help our rural communities."
He said rejection of Senate Bill 32 would punish healthy people living in areas of the state without access to affordable medical insurance coverage. Nothing in the bill precluded a person living in the heart of a city from paying the $50 annual fee to join Farm Bureau and sign a health contract with the nonprofit agriculture organization.
The Senate voted 28-11 on final action to forward the bill to the House.
Sen. Pat Pettey, D-Kansas City, Kan., offered an amendment to weave into the bill the governor's proposal to add 150,000 Kansans to the Medicaid system under the Affordable Care Act. The 2017 Legislature approved Medicaid expansion, but the bill was vetoed by then-Gov. Sam Brownback. Kansas is among 14 states to not broaden eligibility for Medicaid under the ACA.
"Health impacts employment, productivity, academic achievement and financial stability," Pettey said. "Health insurance is critical to good health."
The Senate voted 28-12 to declare the Medicaid amendment ineligible for inclusion in the Farm Bureau bill. The procedural tactic is relied upon by lawmakers to derail an amendment without debating merits of the idea.
Sen. Barbara Bollier, D-Mission Hills, said she was concerned Farm Bureau's policy wouldn't guarantee care for a long list of costly medical interventions. She said the bill did demonstrate the need for Kansas to improve health insurance availability by expanding Medicaid.
"It is hard for me to understand the majority of people here wanting certain people in Kansas to maybe have more coverage and other people in Kansas not," she said.
The Senate also rejected an amendment by Senate Minority Leader Anthony Hensley, D-Topeka, to require Farm Bureau to cover pre-existing medical conditions in accordance with the ACA. The list of conditions would include cancer, AIDS, dementia, mental illness, Alzheimer's, multiple sclerosis, obesity, Lupus and congestive heart failure.
The Hensley amendment was opposed by Farm Bureau, said Senate President Susan Wagle, a Republican from Wichita.
"We should support making coverage more affordable so people can buy it before they develop a pre-existing condition and keep it once they've been diagnosed with one," said Sen. Mary Pilcher-Cook, R-Shawnee.
Outcome of debate in the GOP-led Senate on the Farm Bureau bill wasn't in doubt given the organization's statewide political clout and keen interest among 2019 legislators to demonstrate solidarity with rural Kansans and block a key priority of Kelly, who was elected in November.
Sen. Elaine Bowers, a Concordia Republican serving 7,000 Farm Bureau members in her 13-county district, said 65 percent of farmers and ranchers in a national survey indicated health care coverage was the largest threat to remaining in business. The Senate bill represents a "competitive and innovative" option for Farm Bureau members who don't qualify for ACA subsidies, she said.
"I believe in the free market," said Sen. Randall Hardy, a Salina Republican who doesn't belong to Farm Bureau. "I think that the product offered by Farm Bureau would be a welcome addition."