Sam Brownback's Difficult Decision on Medicaid Funding

So far, Kansas Senator Sam Brownback is opposing extended state aid for Medicaid, even though approving the money would make life easier for future Kansas Governor Sam Brownback.
by | July 27, 2010

There's one more thing that I wanted to mention from my interview with Kansas Senate President Steve Morris: The tough decision Sen. Sam Brownback has to make on state Medicaid funding.

Under the stimulus, the federal government agreed to pay a larger share of Medicaid costs. Since Medicaid is a joint state-federal program and one of the most costly items in state budgets, this enhancement of FMAP (Federal Medical Assistance Percentages) was one of the huge fiscal benefits to states in the stimulus.

With states still in disastrous fiscal shape as legislators wrote their 2011 budgets this spring, many state lawmakers assumed or hoped or begged or prayed that Congress would approve an extension of the FMAP enhancement. Even many Republicans at the state level, including Morris, wanted an extension. The vast majority of governors supported it. At least 30 states included enhanced FMAP in their 2011 budgets, meaning if the Congress doesn't come through with the money they'll have to make mid-year cuts on top of all the cuts they've already made.

So far, though, the Senate hasn't budged. Republican senators are taking a hard line on new spending that would add to the deficit. Democrats don't have the votes to overcome a Republican filibuster.

Morris said he recently had a conversation about FMAP with Brownback, who's in a particularly interesting position. Brownback is the heavy frontrunner for governor in Kansas. Assuming he is the next governor, he could make his own life a lot easier by voting to extend the FMAP enhancements. Who wants to be dealing with painful cuts on top of other painful cuts from your first moments in office?

Brownback's position has been that he wants to support the additional Medicaid funding, but only if it's paid for from money elsewhere in the budget. Maybe Congress will agree on a way to meet that standard, but, if not, it will be interesting to see whether Brownback's position softens as he focuses more and more on his likely future life as a governor.

Josh Goodman
Josh Goodman  |  Former Staff Writer
mailbox@governing.com  | 

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