Funding schools and medicaid expansion were a couple of the hot topics brought by residents during Saturday’s Legislative coffee, sponsored by the Ottawa Area Chamber of Commerce.
The Legislature is still under the gun to satisfy the Kansas Supreme Court in the Gannon Case, which has spanned more than two decades. Rep. Blaine Finch, R-Ottawa and House Speaker Pro Tem, said the court’s latest response was ‘Legislature we agree with most of what you did, but you need to come up with some inflation factor.’
“They gave us the factor of 1.44 percent and said you need to fund that and add that on to what you have done,” Finch said. “Here is the question: What did the court really mean? There are about three or four different theories right now about what they meant by that inflation number.”
Finch said the State of Education office came up with $90 million a year.
“The goal is to get an additional $360 million a year in education,” he said. “That is not 90, 90, 90, 90, that is 90, 180, 270, 360, so by the fourth year you are getting 360 (million) a year into education. So there is already that tension.”
Finch reminded taxpayers the Legislature is in a cycle where a lot of additional money is heading to the education coffers as a bill was passed in the 2018 session to fund education more than $500 million spread over five years.
“There is still $500 million to come, $500 million that is ramping up over the next three years,” Finch said. We are halfway up this ramp to where we have put in about billion dollars into K-12 in the last three legislative cycles. The question is, does the court mean $90 million more a year or does the court mean to build it to $360 million by the end of 2023. That will be the debate this session, to find some consensus around what the court intended with that inflation comment. Then figuring out if we are there yet or if we need to do more. If so, how much more to try to end the litigation. [Nobody] has an idea today how that is going to look by the time it all shakes out.”
Sen. Caryn Tyson, R-Parker, said the Legislature continues to make education funding a priority, but other parts of the budget also need attention.
“We have had presentations before us the past week in over 60 percent of the budget goes for education,” Tyson said. “We are talking about a $7 million budget and over 60 percent of it is education and over 50 percent of it is K-12 education. We have other obligations for the state too. We need to start balancing the priorities. It is going to be a tough argument. It bothers me to say that we have to keep up with inflation [with] any funding. How many in here can say ‘their paycheck increases and keeps up with inflation.’ If we do the math, if your paycheck is not keeping up with inflation, but taxing authorities are taking it at the rate of inflation, you can see where that equation is headed.”
Tyson said the state constitution language may need to be changed.
“We have to address this in our state constitution,” she said. “Otherwise, we are going to be in this vicious cycle of lawsuits. I am not saying stop the lawsuits, I am saying improve the language so it is not ambiguous as to ‘suitability or whatever is adequate.’ Let’s deal with that issue. If we don’t, we are going to continue this cycle of lawsuits that is costly to the states, schools and obviously to the taxpayers.”
Finch said another wrinkle that needs to be explored is KPERS funding should to be tied to education.
“KPERS by the courts decision should be included in education funding,” Finch said. “It is a significant component. For every $180 million or so we put into K-12, there is a $20 million increase in the state’s KPERS contribution. Most of that money goes into salaries. Teachers are part of the KPERS system. When they get paid more, their share into KPERS goes up.”
Both legislators said medicaid expansion will be a topic among both chambers.
“I know it is a priority for the governor,” Finch said. “The lion’s share of medicaid expansion money in the state of Kansas will go to urban centers. Medicaid is a plan that follows the individual, not the facility. We have rural hospitals slated to get $27,000 if we expand medicaid.”
Tyson said medicaid expansion is a federal program that Kansas can’t afford.
“We need a Kansas solution,” Tyson said. “We can’t accept medicaid expansion 100 percent as the federal government has laid it out. There are other states that have customized it, so they can afford it. The reality of it is, the federal government starts out with a program, they pay 100 percent and they decrease their investment in the program. Right now, we are at 90/10. The state picks up 10 percent. That will continue to decrease. If we don’t have a plan to handle that increase as a state, it would not be feasible for us to move on it. We have to understand what we are signing ourselves up for and for future generations.”
Finch said other states are missing the actual costs by right at 200 percent.
“It could be a huge impact to the budget going forward,” he said. “It does not necessarily resolve issues for rural hospitals. What it does do is continue to push money into the urban areas and we will see medical professionals continue to follow that money into urban areas and leave rural hospitals without adequate technicians, nurses and doctors. We have to be very careful of unintended consequences when we talk about massive new spending in a area. If you want to keep those healthcare facilities in rural areas is you have population to utilize the services.”
Finch said federal programs many times are not always practical for individual states.
“The policy choice is that we will have another government program that potentially has federal dollars, but not promised indefinitely going to areas,” Finch said. “We are seeing state after state after state reversing medicaid expansion because they can’t afford to pay the state’s share. Where does that leave the state of Kansas, the three million of us that has to pay the freight. If there is another way to do this that uses true cost containment, a stable budget instead of placing a significant proportion of our budget at risk to the whims of the federal government. A healthy Kansas is where we want to end up. We want people to have people with access to healthcare. We want strong medical facilities in the urban and rural areas. We don’t want people left on the sidelines. There are a significant problems with medicaid expansion that is not being talked about here.”
Tyson said one way to help rural hospitals and patients is to have the federal government issue insurance cards for veterans, which will allow them to use medical facilities of choice instead of VA hospitals, which are in urban areas.
“It is a simple solution that helps everybody,” she said. “Let’s look at solutions like that.”
Finch said Kansas should be leery of any national program at the moment.
“They can’t even keep their doors open right now and we are planning on them to go ahead and follow through on a payment and front 90 percent of the cost for medicaid expansion indefinitely and into the future,” he said. “Every bill we saw on medicaid expansion, if the federal match drops down to about 55 percent, the plan terminates. Which means we will kick people off of coverage in the state of Kansas if the federal government changes its mind. I don’t want to give false hope to the people of Kansas who need healthcare and I don’t want to give false hope to rural hospitals.”
Tyson said there are always strings attached to the federal money.
“How much is it costing us to get that federal money?” Tyson said. “We need to put that equation down on paper. We have to know absolutely what the cost will be before we sign up for the dollars. The return of investment may not be what you think it is.”