The end of last week marked the first major legislative deadline. Unless a bill has been exempted from legislative deadlinesâ€“as most budget and spending bills areâ€“it has to have made it through its house of origin to remain alive at this point in the session.
The activity leading up to these deadlines is often dizzying as individuals work to utilize the legislative rules to advance or kill contentious issues. Perhaps there is no better example of the impact of legislative deadlines and procedural rules on the advancement of political issues than that of Medicaid expansion, House Bill 2064. This bill was scheduled for debate and action in the House Health and Human Services Committee on the last day committees could consider non-exempt bills. The committee discussion was evenly split between those who supported the measure and believe it deserved debate by the entire House of Representatives, and those who felt the unknowns surrounding the federal government's intent to support expansion states and the potential for increased Medicaid costs outweighed the potential benefits, and that action should be delayed to see how Congress addresses the issue when it begins the process of repealing and replacing the Affordable Care Act.
After lengthy discussion, rather than voting to outright advance or kill the bill in committee, a motion was made to table the bill until a later dateâ€“a procedural maneuver effectively killing the bill. The procedural motion tabling the bill passed by a razor-thin margin of 9 to 8. Following the committee's action, proponents of the bill continued to argue that an issue of this magnitude deserved a vote on the substance of the bill, rather than to have it killed by a procedural maneuver. Ultimately, leaders of the House agreed to provide supporters an opportunity to try to amend the Medicaid expansion bill onto another bill being debated by the House chamber.
It was the first time in four years that the full House of Representatives has had the opportunity to debate the Medicaid expansion issue. After four hours of debate, the amendment passed and the bill was forwarded to the Senate with a strong vote of 81-44. So, although the actual bill (HB 2064) was killed in committee, the Medicaid expansion issue has now passed the House and is very much alive for further consideration and possible advancement by the Senate.
This type of action can make it difficult to follow legislative issues, but our bill tracker and this electronic newsletter will continue to update you on legislative action affecting the practice of medicine in Kansas.