TOPEKA, Kan. — Kansas won’t be extending its health coverage to thousands of poor adults under former President Barack Obama’s signature health care law after Democrats and moderate Republicans failed Monday to override conservative GOP Gov. Sam Brownback’s veto of an expansion bill.

The state House voted 81-44 to override Brownback’s veto of the measure, which would have expanded the state’s Medicaid program to cover as many as 180,000 additional adults. But supporters of the bill needed three more votes, or 84 in the 125-member chamber, for the two-thirds majority necessary to overturn the governor’s action.

Brownback has been a vocal critic of the Affordable Care Act, also known as “Obamacare.” The governor argued in his veto message that expanding Medicaid would burden the state with “unrestrainable” costs even though the 2010 national law promised that the US government would pick up most of the cost. Supporters of an expansion said it would help adults who can’t afford to buy health coverage and would help struggling rural hospitals remain open.

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But a few rural Republicans whose support could have led lawmakers to override the veto questioned whether their struggling hospitals would have seen as much benefit from an expansion as urban areas. They also worried that an expansion could complicate efforts to close projected state budget shortfalls totaling more than $1 billion through June 2019.

“What I would love to do is put a solution in place that addresses a lot of concerns that some of us have in a more fiscal-neutral way,” said state Rep. Clay Aurand, a conservative Republican from central Kansas. “I would like to have an expansion, but I would like it to be a Kansas plan.”

Thirty-one states have expanded their Medicaid programs under the Affordable Care Act, including some with Republican governors.

Brownback previously could count on fellow GOP conservatives who opposed the former Democratic president’s policies to block a Medicaid expansion. But voters last year turned on him and elected more Democrats and moderate Republicans to the Legislature, forcing a debate.

Also, advocates for the uninsured never abandoned their push, and the Kansas Hospital Association backed an expansion, believing it could keep dozens of rural hospitals open. Kansas’ Medicaid program covers about 377,000 poor, disabled and elderly residents, but poor adults under 65 who aren’t disabled and don’t have children aren’t eligible.

Brownback and other critics argued that expanding Medicaid as contemplated by the bill would have shifted the state’s priority from helping vulnerable, disabled residents to providing health coverage for “able-bodied” adults. But supporters said that wasn’t so and relied on projections from the Kansas Hospital Association saying extra federal dollars would ripple through the economy and result in a net plus for the budget.

“God forbid we help people get health insurance,” said freshman Rep. Tim Hodge, a Democrat who represents a district north of Wichita.

— John Hanna

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