The effort to expand Medicaid in Kansas fell apart Monday as the House failed to override Gov. Sam Brownback's veto of a bill that would have expanded the health care program to thousands of low-income people in the state.
The 81-44 vote, three shy of the 84 needed to overcome the governor's opposition, effectively ends the Medicaid expansion push in Kansas after it successfully passed both chambers with bipartisan support earlier this year.
"People expect me to have a smile on my face and to be happy," state Rep. Dan Hawkins, a Wichita Republican who opposes expansion, said after the vote. "It's tough, it's hard. It's a hard-fought battle on both sides. I don't know that there's any joy. It is what it is."
Under the Affordable Care Act, also known as Obamacare, states can expand Medicaid to low-income people. A hefty federal match covers most of the cost of expansion.
The legislation vetoed by Brownback would have expanded KanCare, the state's privatized Medicaid program, to roughly 150,000 people in the state.
Conservative lawmakers in the Kansas Legislature have strongly opposed the expansion legislation, saying that it would hurt the state's finances as the state faces projected budget shortfalls of more than $1 billion through June 2019.
They also have pointed to possible changes on the federal level, where the Republican-controlled Congress and President Donald Trump have advocated for a repeal and replacement of Obamacare.
Although that federal push has stopped for now, lawmakers in Kansas have said they still do not trust the federal government to continue to pay its end of the Medicaid expansion effort.
"This bill, it would have plunged Kansas into debt and it would not have helped our most vulnerable citizens," said state Sen. Mary Pilcher-Cook, a Shawnee Republican. "Because of that, I have to be relieved that they were able to sustain the veto. I think that is what's best for Kansas."
But other Republican and Democratic lawmakers have strongly supported expansion, saying that expanding Medicaid in the state is the right thing to do.
They worried that without expansion, Kansans' health would suffer and more hospitals whose patients may have relied on Medicaid expansion could have to close.
But even after the defeat Monday, some lawmakers already were saying they plan to continue to push the issue in Topeka.
"We were so close," said state Rep. Susan Concannon, a Beloit Republican who has helped lead the expansion effort.
House Minority Leader Jim Ward, a Wichita Democrat, said he was frustrated that the House fell three votes short.
"Kansans overwhelmingly support Medicaid expansion," Ward said. "The question is who do those 44 people represent: the governor, Americans for Prosperity, the Koch brothers? They certainly didn't represent the people of Kansas today."
Expansion supporters lobbied lawmakers over the weekend in hopes the bill would get enough support to overcome the governor's veto.
But the effort wasn't enough to change the legislation's fate.
Melika Willoughby, the governor's spokeswoman, said in a statement: "The House served their constituents well today. While Congress and the president continue to discuss the future of health care, not expanding Obamacare is the right choice for Kansas."
David Jordan, director of the pro-expansion group Alliance for a Healthy Kansas, said it was disappointing to see so many lawmakers side with the governor.
"They voted to really set our state backwards and make sure we're a have-not state," Jordan said. "They voted against the best interest of Kansans today.
"It's just groundhog day," he said.
And unless changes are made at the federal level, Doll said, he was hopeful lawmakers would push the issue again next January at the start of the 2018 session.
"I think it's going to happen," he said about expansion becoming law. "I just don't know when."
(The Star's Bryan Lowry contributed to this report.)
(c)2017 The Kansas City Star (Kansas City, Mo.)