To achieve the foundation’s mission, we believe it is essential to invest in advocacy and public policy activities and to engage more directly as an organization on specific state and federal policy issues that present the opportunity to improve access to health coverage and strengthen the health care safety net.
In a historically short session—led by an emboldened supermajority able to override Governor Laura Kelly’s vetoes—the 2025 session of the Kansas Legislature produced notably few wins for population health, while enacting policies that many advocates fear will ultimately undermine the health of Kansans.
We note here a few of the most salient policy actions taken by state elected officials relative to the REACH Healthcare Foundation’s policy agenda, which was informed by our grantee partners and the health advocacy community, and encourage advocates to continue their outreach to elected officials throughout the coming summer and fall.
Despite several attempts by Democratic lawmakers to offer floor amendments to Medicaid expansion bills during the session, all failed. No committee hearings were granted on expansion proposals. Kansas remains one of only 10 states that hasn’t expanded Medicaid eligibility. Meanwhile, the state has foregone billions of federal funding that could have been used to improve access to affordable coverage for nearly 150,000 Kansans, provide additional financial protection for struggling hospitals and providers, and enhance the state’s healthcare workforce.
One notable win related to Medicaid came when the House opted not to override the Governor’s line-item veto of a budget proviso that would have effectively ended continuous enrollment for parents and caregivers in KanCare, the state’s Medicaid program. The Senate voted to override the veto as part of an unprecedented maneuver of considering all budget line-item veto overrides in one packaged motion. The House, to its credit, separated out several line-item vetoes due to their potential adverse impacts. This line-item veto was ultimately sustained, preventing Kansans caring for loved ones from losing coverage due to red tape, and avoiding an additional $3-4 million each year in administrative expenses.
A bill was passed requiring most changes to the state’s Medicaid program to be reviewed and signed off on by the Legislative Coordinating Council (LCC), rather than the Governor as has been the case for decades. Given the hundreds of changes that occur to federal Medicaid and the Medicaid state plan on an annual basis, this may prove problematic. Most federal changes require a timely response from the state and many question the value of adding this new layer of administrative oversight. Similar attempts to undermine Executive Branch authority are expected to continue next session.
A drafting error in a CHIP-related law enacted in 2008 permanently set the program’s income eligibility poverty level in state statute at that year’s value, rather than having state income eligibility tied to the current year’s federal income eligibility level. This clerical error has required a corrective proviso in the annual budget every year since. Despite support in the House to make the fix permanent, Senate majority leadership did not take up the matter, saying they would study the issue further before the 2026 legislative session.
Voter engagement is an important contributor to individual and community health. Legislation passed this session repealed the existing “three-day grace period” allowing advance ballots postmarked on Election Day to still be received and counted. Governor Kelly vetoed similar proposals in recent years and those vetoes had all been sustained, but not in this session. Advance ballots must now be returned to county election offices by 7pm on Election Day to be counted, creating barriers for military members serving abroad, out–of–state college students, and rural and elderly populations dependent upon increasingly unreliable mail service for timely delivery. We expect further legislation restricting voter access to be introduced next session.
Like Medicaid expansion, maintaining a strong, robust 340B program to provide access to necessary medicines is critical for patients, hospitals and safety net clinics. Big Pharma and insurance companies have been pushing states to limit participation in this federal program, posing barriers for patients to easily access their medications, particularly in rural and underserved communities. The Senate wisely proposed and passed a bill to prohibit manufacturer interference relating to prescriptions distributed under the 340B program, but no action was taken by the House. We expect this measure to be back in 2026.
The 2024 Legislature set aside $4 million to allow Federally Qualified Health Centers (FQHCs) to lay the groundwork to become Certified Community Behavioral Health Clinics (CCBHCs). During its consideration of the 2025 budget, the Senate diverted those funds to substance abuse treatment programs, making them no longer available to FQHCs. Although FQHCs may eventually have an opportunity to become a CCBHC, this funding diversion will make those efforts more difficult.
Efforts continued this session to further undermine the ability of local health departments to act in the best interest of the public’s health. Most notable was a bill that would prohibit local health officials from banning public gatherings during a public health emergency. Governor Kelly vetoed this measure, but that veto was overridden, and the measure is set to become law.
A silver lining this session was the passage of a bill which codified, among other things, the funding formula for local health departments. Putting the formula in statute ends the need for an annual temporary fix in the budget, supports core public health functions, and hopefully leads to more stable funding.
Vaccine opponents capitalized on the Governor’s longstanding priority to consolidate several departments focused on early childcare and child development services. Although legislation to create the new Office of Early Childhood passed with bipartisan support, the Governor’s original proposal was amended to incorporate weakened childhood vaccination standards in childcare settings. Additional efforts by vaccine proponents to remove the loosened vaccine requirements failed. Despite the likely negative impact on childhood vaccination rates, the Governor signed the bill into law.
Despite the decisive failure of a 2022 proposed constitutional amendment limiting a woman’s right to an abortion in Kansas, legislators continued to introduce and pass bills aimed at restricting abortion access and reproductive health. Perhaps the most significant of these was a provision that was amended into HB 2062 which sought to offer child support payments to a mother from the date of conception. This cementing of the concept of “fetal personhood” into state law likely lays the groundwork for future efforts to chip away at abortion rights. Governor Kelly vetoed the bill, but it was quickly overridden.
One of the first legislative proposals considered this session centered around eliminating access to gender-affirming care by minors despite hundreds of pieces of testimony provided by opponents, medical and mental health experts in committee hearings. SB 63 was a proposal similar to ones previously vetoed by Governor Kelly. This measure was passed by the legislature early in the session and was eventually enacted over the Governor’s veto.
Dovetailing with efforts at the federal level, heightened attacks on state-level DEI programs within government and institutions of higher education continue. Budget provisions to target DEI programs were advanced this session by adding language to require the Governor and Department of Administration to eliminate DEI mandates, policies, programs, preferences and activities, among other considerations. The original bill language also removed funding from the Governor’s Office and Dept. of Administration budgets until the proposed law’s conditions were met, but the funding restriction components were eventually dropped from the proviso.
Various measures to compel the Governor to cooperate with federal immigration efforts were also initiated this session. Most were either substantially diluted or did not advance through the legislative process. One measure of note did pass—a Constitutional Amendment requiring individuals to be citizens of the US, along with being 18 years of age and a resident of a voting area, in order to vote. Opponents argued these requirements are already covered in the State’s Constitution, but nonetheless this “clarifying language” passed by a 2/3rds majority of both Legislative chambers and will be on the ballot for voters to consider in 2026. Another immigration-related proposal—SB 254—would have repealed in-state tuition for undocumented students and prohibiting aliens who are unlawfully present in the US from receiving any state or local public benefit in accordance with applicable federal law. The bill passed out of the Senate Federal & State Affairs Committee but was never considered by the full Senate. Intensive opposition by advocates kept this bill from moving further.
REACH supports the work of our Missouri advocacy partners and develops an annual policy agenda to guide the foundation’s engagement on state and federal policy issues that present the opportunity to improve access to health coverage and strengthen the safety net.
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