House blocks debate on Medicaid expansion on procedural grounds

The House rejected an attempt Wednesday to force a debate over Medicaid expansion amid work on the state budget.

Representatives voted 85-37 to block a Medicaid expansion package on procedural grounds.

The House was debating budget legislation as the Legislature attempts to close a projected revenue shortfall of at least $175 million next fiscal year, which begins July 1. Rep. Jim Ward, D-Wichita, offered an amendment that would expand Medicaid.

States that expand eligibility for the program up to 138 percent of the federal poverty level can receive additional federal funds to help pay for the costs of expansion.

Republicans challenged the amendment, arguing it violates legislative rules that prohibit lawmakers from adding additional spending into the budget during floor debate unless the increases are offset with decreased spending elsewhere — provisions known as “pay-go” rules.

“It doesn’t spend any money. If you allow this ruling to stand, you are denying amendments always because we always move money from one part of the budget to another part of the budget when we do amendments. This is wrong to deny us, to use the rules, to abuse the rules in this way,” Ward said.

The House’s rules committee found Ward’s amendment out of order. Ward appealed the ruling, forcing a brief debate. Rep. Ron Ryckman, Jr., R-Olathe, said the amendment clearly spends more money.

“I don’t think there’s any question in our minds this spends more money. And it would be a violation of pay-go to spend more money,” Ryckman said.

Rep. Tom Sawyer, D-Wichita, argued the amendment doesn’t specify an additional amount of spending. He said lawmakers insert budget provisos all the time that authorize expenditures.

“We’re setting a new precedent today saying if you’ve got a proviso telling an agency to do something, no matter how small that task may be, that means you have to spend some money to do that task,” Sawyer said. “We’re saying now that would be a violation of pay-go.”

In the vote, Democrats and some moderate Republicans voted to overturn the ruling and allow debate on Medicaid expansion, while conservative Republicans led by House leadership upheld the ruling.

Last year, the House Vision 2020 Committee put forward a Medicaid expansion package, though it wasn’t debated on the House floor. It isn’t entirely clear House leadership would have enough votes to stop expansion from passing the chamber if it was brought up for a vote.

Before the 2016 session, House Speaker Ray Merrick, R-Stilwell, also took three Republicans off the House Health and Human Services Committee. All three of the lawmakers are supporters of expansion.

The procedural debate Wednesday in some ways mirrored a Tuesday Senate debate. In that debate, senators rejected an attempt by Sen. Mary Pilcher-Cook, R-Shawnee, to include Medicaid expansion on a bill to require step therapy for Medicaid patients.

Pilcher-Cook, a fierce opponent of expansion, brought up the amendment with the intent to vote it down — she said to send a message to the House. But senators never voted on the amendment because it was ruled as not germane to the underlying legislation.

Pilcher-Cook appealed the ruling, but was rebuffed in a 22 to 15 vote. Senate President Susan Wagle, R-Wichita, opposed Pilcher-Cook’s appeal. She said the vote was about upholding the chamber’s rules.