Bill Black: Kansas Legislature Slips Koch Noose, Authorizes Medicaid Expansion

Yves here. Is Thomas Frank’s “What’s the Matter With Kansas?” starting to become a thing of the past? This story is important because you have a Republican state legislature both bucking austerity orthodoxy and acknowledging that voters want and need more government paid health care.

By Bill Black, the author of The Best Way to Rob a Bank is to Own One, an associate professor of economics and law at the University of Missouri-Kansas City, and co-founder of Bank Whistleblowers United. Jointly published with New Economic Perspectives

The good news is that the Kansas legislature, the land of the lunatics, experienced an outbreak of the reality virus (first diagnosed and named by Steve Keen among neoclassical economists). The bad news is that the Kansas’ Crazy-in-Chief, Governor Sam Brownback, has proven immune to the virus.

Brownback decided to put Art Laffer in charge of Kansas’ taxation policy. Even neoclassical economists roll their eyes when it comes to Laffer’s claims that dramatic tax decreases lead to significantly increased net tax revenues. Laffer’s batting average on this claim is .000 and his “proof” of his claim is a graph (the “Laffer curve”) that he drew that contradicts reality. Brownback knew that Laffer was batting .000 on his claims and that Laffer never drops his claims when reality (repeatedly) falsifies his graph. To no one’s surprise, Brownback’s tax cuts produced a fiscal disaster for Kansas.

Brownback also launched an unholy war against the people of Kansas in other spheres vital to their lives, including health care and education. In particular, Brownback denied 150,000 Kansans access to the Medicaid expansion that was a pure win-win for the State and its citizens. Brownback, with the aid of the Koch brothers, launched a purge of Republican state legislators to remove “moderates.” (Actually, they were true conservatives.) This spread Brownback’s delusions throughout the Republican-dominated legislature. Kansas’ Republican legislators, therefore, should have been among the people most resistant to the reality virus, particularly so soon after the delirium of Trump’s victories.

The timing and the location of this outbreak of the reality virus in Kansas, therefore, offers us new hope for America. As a bonus, the Wall Street Journal reported the reality outbreak.

The Kansas Republican-led legislature voted to expand Medicaid under the Affordable Care Act on Tuesday, a move coming just days after Republicans in Washington pulled their bill to repeal and replace the law known as Obamacare.

Buoyed by moderate Republicans and Democrats, the Kansas state Senate voted 25-14 for a bill that would expand Medicaid, the state-federal health-insurance program for the poor, elderly and disabled, to cover more than 150,000 additional nondisabled adults.

As an important side note that is contrary to the coverage of Trump’s failure to “repeal and replace Obamacare,” the media could have spun the story in a very different direction. Ryan/Trumpcare (“Rumpcare”) was an awful piece of legislation that would have harmed tens of millions of Americans, given an enormous tax cut to the wealthy, and badly eroded the Medicaid safety net. The Rumpcare bill was nastiest to Trump’s most loyal voters – older, non-wealthy Americans. Many readers know that the March 13, 2017 Quinnipiac poll found that 17%t of Americans supported the bill – 13% of women. What few people know is that only two months earlier the same polling service reported very different results on January 12, 2017.

American voters are divided 48 – 47 percent on whether President-elect Donald Trump should support efforts to repeal Obamacare, the 2010 Affordable Care Act (ACA), according to a Quinnipiac University national poll released today.

The dramatic, rapid change in opinion demonstrates that Obamacare is deeply unpopular with many Americans and proves that Speaker of the House Ryan remains a heartless Ayn Rand groupie and is a policy wonk fraud. The Quinnipiac poll showed that Americans listened to the experts and realized that Rumpcare would cause many Americans to lose their health care. Even in the era of Trump, most Americans are not immune to the reality virus.

But what of Kansas, which has repeatedly voted for Brownback as U.S. Senator and Governor – are Kansans still immune? It turns out that Kansas’ Republican legislators became less far right in 2016. The abject failure of Laffer’s nostrums convinced many Kansas Republicans to vote for legislators who were conservative Republicans instead of Koch-head Republicans. The newly-elected Kansas Republican legislators that hade detoxed from their predecessors’ Koch addiction then did the thing that terrifies the Koch brothers, Trump, Ryan, and Brownback – they began gathering the facts and embracing reality.

Kansas state Sen. Barbara Bollier, a Republican and retired physician, said the bill was motivated by the stalemate in Washington over health-care overhaul and a need to act immediately to protect residents of the state.

She said she supported the bill because she believes Kansas residents should be provided insurance coverage. “They should have the opportunity to live without the horrific stress of the fear of a significant illness or trauma that would potentially bankrupt them if they didn’t have access to insurance.”

Proponents of the bill, Ms. Bollier said, submitted 190 pieces of written testimony from virtually every provider of care in the state in support of expanding Medicaid.

John Doll, also a Republican state senator, said he voted for the bill after speaking to the 10 hospitals in the district he served, all of whom wanted the Medicaid expansion.

“The people I served overwhelmingly asked for it,” he said, adding the issue of public health should be bipartisan and based upon what is best for the state’s residents rather than political affiliation.

When people tell you that it makes no difference to resist and educate elected officials, remind them about the Kansas legislators. Then warn them how much work it takes. Brownback will probably veto the bill adopted by the Kansas legislature expanding Medicaid.

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  1. marym

    Brownback privatized Medicaid in 2013.

    Announced this month:

    “All three of the private insurance companies that manage the Kansas Medicaid program made a profit on it in 2016 — the first year that has occurred.

    UnitedHealthcare was by far the most financially successful of the three, with $30.2 million in profits. Sunflower State Health Plan, a subsidiary of Centene, had a $5.5 million profit and Amerigroup made about $3.4 million.

    The three companies lost millions in 2013 and 2014, the first two years of KanCare.“

  2. flora

    2 years ago, 1 year ago, this legislation wouldn’t have been allowed up for a vote on the floor. Then last year’s primary and general elections defeated at least 11 of Brownback’s staunchest far-right GOP allies in the House and Senate, including the GOP Kansas Senate majority leader.
    Kansans are mostly Republican and also mostly moderate. They were fed up with Brownback’s radical “real time experiment” and voted out a lot of his worst AFP-backed allies. Now the legislature has passed Medicaid expansion. Even with a dire budget they have passed Medicaid expansion, and have refused to cut any more K-12 funding.

    ” Brownback, with the aid of the Koch brothers, launched a purge of Republican state legislators to remove “moderates.” (Actually, they were true conservatives.) This spread Brownback’s delusions throughout the Republican-dominated legislature. ”

    That purge was in 2012. It was accomplished by AFP running stealth far-right candidates against incumbent GOP moderates in their primaries. In 2016 a coalition of moderate GOP and Dems, including 4 prior governors – 2 GOP and 2 Dem – organizing a push back against Brownback’s radicals by recruiting good, moderate candidates in both parties. Several of the GOP radicals were defeated by moderate Republicans in the primaries. Several more were defeated in the general election by moderate Democrats. There was nothing partisan in this effort. It was about saving Kansas and Kansans from lunatics pushing a “real time” disaster.

    Thanks to Bill Black for writing this important post.

    1. Clive

      Thanks, I didn’t know that public education was also being added to the line in the sand. I think the protection of K-12 budgets is if anything more symptomatic of an “enough’s enough” sea-change in even the right-of-centre mainstream.

      While we talk a lot about healthcare as the anti-neoliberalism lightning rod (which indeed it is), education — especially the academyisation fraud — is possibly more likely to provoke genuine loafers on the ground activism. Most people in my circle are generally a bit “meh” at political engagement even if it’s for healthcare and they have to have had a bad experience with crapified provision to make them even vaguely question things. It has to be really bad to make them do anything.

      But education, well, given the pressure on parents to “safeguard their children’s future” and how high the stakes are, it doesn’t take much to get even my very conservative and generally free-market-fundamentalism friends to march down to county hall and berating their councillors or school governors.

      1. Left in Wisconsin

        Maybe it’s the same across the pond but here in flyover, there are 3 distinct public education systems:

        1. Big urban – always pretty bad (but not historically as bad as received wisdom, at least through about the 1980s – lots of very successful people did quite well is big city school districts till then) but due to disinvestment (perhaps not exclusively) really, really bad now and almost all minority so (virtually) no one else cares.
        2. Suburban – excellent public schools but home to most of the legislators that want to ruin everyone else’s public schools. Having absconded with virtually all of metro-area wealth, they can afford truly excellent schools and affordable property taxes (the main way schools are funded here, or at least the main variable in school funding, as state contributions tend to be relatively fixed per-student)
        3. Rural or small town – where the rubber hits the road. In most of these places, the school is the main provider of local identity, and there are no charter or voucher alternatives anyway. But the areas are being depopulated, there is no tax base, and all the legislators are Republican (mostly understandably, given the Ds distaste for rural rubes). The whole Koch mindset makes a certain kind of intellectual sense out here but doesn’t address their problems. Having said that, while the Rs need the rural vote, virtually none of the money that runs the R machine comes from here, and they (the R establishment) are mostly happy to provide lip service, and that alone, to these voters and citizens. The fact is, good rural schools are really, really expensive (no economies of scale, high transportation costs).

        In Wisconsin, the anti-Walker opposition thought locals would rally around their public schools and their teachers in 2011. They didn’t. But in this upcoming budget, Walker is proposing a more-than-token increase in school funding, aimed disproportionately at rural schools. So maybe there is a breaking point.

        1. PrairieRose

          I’ve been meaning to thank you, Left in Wisconsin, for your always thoughtful remarks. You have a knack for bringing your boots-on-the-ground narrative alive for the reader. Much appreciated, and this is from a neighbor in Minnesota. Please keep sharing.

  3. Altandmain

    Somehow I think Brownback will stick to his guns until the very end. He must be expecting some sort of a big payday here.

    Maybe the Kochs will reward him for his loyal service to them with a lot of money.

  4. Salty

    Pay attention to this stuff. Nobody would expect a revolution to come from someplace like Kansas, which is why that’s exactly where it’s going to come from. When you’ve been written off, you have nothing to lose.

  5. ex-PFC Chuck

    Two awesome instances of meme coinage in one piece! “Rumpcare” and “Kochhead.” May they live on in the memeosphere. Mr. Black.

  6. aj

    I read somewhere recently that Laffer claimed the cuts didn’t work because they weren’t big enough. I’m always reminded of Warren Mosler’s story about the carpenter who keeps cutting off pieces of a board little by little, while complaining that, “No matter how much I cut off, the board still isn’t long enough!”

    Glad to see that the actual people of Kansas and the state legislators are starting to come around. Maybe they are familiar with the #1 Rule of Holes. That is, if you find yourself in a hole, stop digging. Brownback has enough Koch money, he has nothing to lose. But, there are real people in Kansas that do.

  7. johnnygl

    Very important piece. Perhaps the most important lesson to be learned here is that the death of democracy has proven to be greatly exaggerated.

    Score one for real people!

  8. ger

    It is good to see a glimpse of true bipartisanship that benefits the deserving. The neoliberal financial disaster that defines Kansas has been under the radar for too long as the media concentrates on personalities instead of reality. The meme a political unit can cut taxes on the vulgar rich and increase revenue does not get enough press from alternate news.

  9. Left in Wisconsin

    Speaking of the need to educate people, I had one of those aha moments reading the letters to the editor in the local paper today. Maybe others got this way before I did but I finally feel like I understand why so many people not directly affected (not having to get insurance on the exchanges) hate Obamacare so much. Here is the letter:

    I am disheartened and disgusted with the entire political system. The Democrats screwed up health care in this country and cheer about helping “the American people.” In fact, the minority and many undocumented people are the winners, and the rest of us are paying the bills.

    My children, who get their health care provided through their employers, are paying much higher premiums and deductibles than they were before the Affordable Care Act was voted in by the Democrats. Their incomes have gone way down because their cost of health care has gone way up.

    This is not something to be celebrated by the majority of hardworking Americans. What a mess the representatives in our government have created. We, the American middle class, are all the losers as we are stuck paying for the government mandates.

    I challenge the Democratic representatives we have elected in our area to fix this mess they created. Instead of caring more about the minority, how about showing compassion for the majority for a change. Roll up your sleeves and clean up the mess you have created.

    I have long understood the need to educate people on how our ‘welfare state’ works – how chintzy it is, how virtually no one (always exceptions) is ‘winning’ on government benefits, esp immigrants. But I didn’t get the fact that people would blame O-care for out-of-control health care industry costs (which is not to argue that it has done much to bring them down). IOW, believing that costs would not be out-of-control if not for Ocare.

    I actually think we have made huge progress toward single payer in the last year. I don’t think we can get there until 1) Ocare actually does ‘fail,’ which seems much more likely now that if HRC was press and 2) people see that nothing else can get us better healthcare for less, which is the promise made and what people want, but that single payer can. Obviously, the education part is the easy part; taking down the medical industrial complex the harder. But a year ago I would never have imagined the conversation would be where it is now.

    What Black shows is that, while there will always be a percentage that is reality-resistant Brownback-ites, even many who identify as conservative are or will be reachable as the Trump-Ryan-Koch BS train fails to solve their problems.

    1. RUKidding

      Thanks for that letter. It’s annoying that the author is still blaming minorities and immigrants for getting all kinds of super benefits that no one else does. However, I can also confirm that my employer-provided health insurance costs have risen substantially since ACA was enacated, and I am certainly getting much less coverage for more money. That said, I’m not certain that this wouldn’t have happened anyway as costs were on the rise before ACA. IOW, I have no real way to tell if I’d be: a) better off, b) worse off, or c) the same without ACA. Costs are out of control. Period. The End. And that’s what ACA failed to tackle.

      I am heartened to see more conversations happening about single payer and medicare for all. I am heartened to see more and more citizens talking about: let’s look at other westernized nations who provide much better health care systems than we do, and copy one or more of them.

      8 years ago when Obama was ramming ACA down our throats, most citizens were still screaming about how horrible and terrible the health care systems were in places like Canada, the UK, France and Germany. Now I hear more people praising the health care systems in those countries and saying: why can’t we do that here??

      That, for me, is one huge step. I am no longer hearing all the noise about how Team USA simply has “The BEST” health care system in the world. I don’t know anyone, personally, who feels that way anymore, albeit there are still weak protests (and getting weaker) about so-called “socialism” if we have Medicare For All. There is that vast great fear that someone poor might get something “better” than what I get. Heaven forfend!

      I hope we can make progress on this front.

      1. run75441

        Wow, the silver bullets Medicare-for-all and single payer. Canada is single payer and UK is socialize med. France, Germany and most of Europe is a combination of public and commercial. Why can the latter work there and not in the US is the question to be asked.

        Brooking did a nice little study on costs and here is a link to the Health Affairs Blog you can read their version of it.

        “Covered California, that state’s marketplace, just announced premium increases averaging 13.2 percent. But even if premiums increase by the 10 or 15 percent overall that some are predicting for 2017, they will still be far lower than premiums otherwise would have been in the absence of the law. Moreover, this analysis does not include the effects of premium and cost-sharing subsidies that serve to make ACA marketplace plans more affordable for many people.”

        Don’t take my comment as criticism. You do have it correct, the ACA/PPACA/Obamacare was not allowed to actively control the rising cost of healthcare. When it got down to one last effort to go for a Public Option, the Senator from Aetna who is presently shilling for the DeVos family Joe Lieberman said no way.

        Medicare-for-all and single payer will suffer the same fate of inability to control the rising costs of commercial healthcare if the government does not begin to tell the commercial healthcare industry what it will pay for pharma, doctors, hospital supplies, and hospital stays. This is what happens in Europe and in Germany which has well over 100 commercial healthcare sickness funds. You have the right idea amongst all the others.

  10. RUKidding

    Good to know. I know some people who’ve moved away from Kansas because how badly run it is. They couldn’t stand Brownback and the ultra-NeoLib state govt. Said it totally ruined the state. Glad to see the locals are fighting back for THEIR rights.

  11. Lune

    While this is heartening, I wouldn’t read too much into it just yet. Obamacare provides 100% federal funding for the medicaid expansion, drifting down to 90% by 2020 and staying there. It is literally free money. There is virtually no sacrifice being asked of Kansans to accept this money.

    While Republican govs were crazy enough to reject it regardless, finally agreeing to take free money is hardly a big step in re-entering the reality-based world. And there are very few decisions in govt. this easy to make. When the legislature starts making actual sacrifices of their Koch agenda in service of their citizens’ interests, that’s when we’ll know the reality virus has truly bitten.

    1. ScottB

      That 10 percent state portion is not insubstantial. Here in Oregon we’re looking at big service cuts statewide, in part due to the medicaid bill coming due. We’re at near-record low unemployment, several years of strong job growth, and budget cuts. Wait till we get a recession.

    2. JustAnObserver

      From an ultra-libertarian/neoliberal point of view everything the government does has to be a negative, painted in the deepest shade of black available. Since the Medicaid expansion parts of ACA violates this by a very long way it has to be resisted by “all means necessary” no matter how much damage it even to their own “base”.

      There was a commenter (Sorry can’t remember the handle) the other day who recalled his grandfather’s enduring memory of electricity coming to rural Arkansas (?) courtesy of FDR. For the Kochs and their ilk such memories must never, ever, be allowed to take root again.

      So the – Koch funded/bought – Republican govs were/are not “crazy” in their own hermetically sealed world. They are acting out the direct consequences of their (poisonous) ideology. They’re nothing if not consistent.

  12. PKMKII

    Much as there’s a divide growing in the Democratic Party between the progressive/left/berniecrats and the neoliberal/establishment/big money wings, the debacle on Repeal and Replace, and healthcare generally, highlights the divide in the Republican Party as well. We’ve got our ideological, tea party, semi-libertarian (Austrian on social services, Keynesian on police and military) Freedom Caucus wing, the right wingers who started believing their own marketing. On the other side, I wouldn’t call them establishment Republicans as that invokes the neo-cons, who are largely still wandering the desert outside of some Dubya-era bureaucrats. More, what the Republican establishment meant prior to Reagan: Hawkish, but without the military adventurism of the neo-cons. Err on the side of lower deficits, but not afraid of tax hikes nor necessary spending. Hence, our Kansas Republicans bucking the Tax Club for Growth dogma. The irony being though, as the healthcare fight showed, that despite tapping into the same anxieties and dog whistles as the tea party anti-statists, Trump is clearly in the new old-fashioned Republican camp. So this is just a preview of what’s to come.

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