The state Senate voted 25-14 for a bill that would expand the state's Medicaid program for the poor, disabled and elderly so that it would cover up to 180,000 additional non-disabled adults. The House approved the same measure last month, meaning the bill now goes to conservative Republican Gov. Sam Brownback.
The governor has long been a vocal critic of the 2010 federal health care law championed by former President Barack Obama. Brownback declared in January that expanding Medicaid under the law would be "airlifting onto the Titanic."
Brownback hasn't said whether he would veto the bill, but lawmakers on both sides of the debate expect it.
The bill had strong, bipartisan majorities in both chambers. The votes reflected elections last year that put more Democrats and moderate Republican in the Legislature and years of pressure from advocates for the poor and hospitals. Hospitals expect an expansion to help them, especially in rural areas.
Supporters of the bill would need 27 of 40 votes in the Senate, and 84 of 125 in the House, for the two-thirds majorities necessary to override a veto.
The debate in Kansas had been clouded by uncertainty about what Republicans in Congress would do with health care policy as they helped Trump fulfill his campaign pledge to repeal Obama's signature policy. But their push collapsed last week, aiding efforts to expand Medicaid in Kansas and other states, including Maine, North Carolina and Virginia.
"I don't believe that we can wait for D.C.," said Sen. Vicki Schmidt, a moderate Topeka Republican and chairwoman of the Kansas Senate's health committee. She supports expanding Medicaid.
Top Republicans in the state Senate opposed the bill. Senate President Susan Wagle, a conservative Wichita Republican, said she expects Congress to tackle health care again by 2018.
But Matt Salo, executive director of the National Association of Medicaid Directors, said that's unlikely given that dissention within the GOP would force Trump and other Republican leaders to work on a bipartisan plan.
"There's no way that a bipartisan approach is going to yank the rug out from under Medicaid expansion," Salo said.
Obama's Affordable Care Act encouraged states to increase the number of people eligible for Medicaid by promising to pay most of the costs. Thirty-one states, including some led by GOP governors, have expanded Medicaid.
Kansas' Medicaid program covers about 377,000 poor, disabled and elderly residents, but poor adults under 65 who aren't disabled and don't have children are not eligible. Brownback wrote in a letter with other GOP governors to congressional leaders last week that expanding Medicaid under Obama's policies moved the program away from its "core mission" of helping the truly vulnerable.
Associated Press writer Allison Kite contributed to this report.
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