How Blue Cross and Blue Shield and the Kansas Chamber allied against consumers in their fight against KanCare
While everyone is talking about the fallout from the Big Beautiful Bill and its devastating impacts on Medicaid recipients, Kansas has been locked in its own fight over healthcare access. The question of expanding KanCare to cover more than 150,000 additional Kansas has dragged on for years, and once again the efforts have been left to die.
For almost eight years, Governor Laura Kelly and the Kansas Democrats have been pushing to expand KanCare. This effort gained momentum after the passage of the American Rescue Plan Act (ARPA) in 2021, which offered generous incentives for states that had refused expansion, covering 90% of the initial cost and adding a 5% bonus to the federal match for all existing Medicaid enrollees for two years.
Governor Kelly’s Health Adult Workforce Kansans (HAWK) bill was written with this federal funding in mind. The Kansas Health Institute (KHI) estimates that expanding KanCare would cost the state roughly $65 million for the first two years. In comparison, the federal government would cover the remaining $502 million during the first two years. The total estimated net
cost to the state over 10 years was $171 million. The bill would extend healthcare coverage to about 150,000 low-income Kansans, including more than 60,000 children, create over 23,000 new jobs in the first year, stabilize more than 30 rural health centers at risk of closure, and protect working Kansans from falling into medical debt. With over 75% of voters supporting expansion, the question is obvious: why hasn’t it passed?
While many Kansas Democrats point fingers at Republican leadership in Topeka, they tend to skip over who the real culprits are: insurance companies, corporate lobbyists, and the capitalist mouthpieces inside the Kansas Chamber of Commerce.
Just like in national politics, Kansas politicians are effectively bought and paid for by mighty corporate-aligned PACs. Here, that means the Kansas Chamber PAC and the Blue Cross and Blue Shield PAC. These organizations funnel tens of thousands of dollars every year into Republican candidates who work tirelessly to kill KanCare expansion and undermine healthcare reform like HAWK.
In the past year alone, Blue Cross and Blue Shield KC PAC donated upwards of $7,500 to Republican legislators who all voted against the HAWK bill, with the Kansas Chamber of Commerce being busy as well, spending nearly $50,000 to support Republicans opposed to expansion.
| Politician Name | Total Donations (BCBS KC) | Total Donations (Kansas Chamber) | Political Party | On the Insurance Committee? |
|---|---|---|---|---|
| Chase Blasi | $500 | $1,000 | R | No |
| Avery Anderson | $500 | $500 | R | No |
| Blake Carpenter | $500 | - | R | No |
| Patrick Proctor | $500 | $500 | R | Yes |
| Bill Sutton | $500 | - | R | Yes (Chair) |
| Larry Alley | $1,000 | $1,000 | R | No |
| Chris Croft | $500 | $500 | R | No |
| Patrick Penn | $500 | $500 | R | Yes (Vice Chair) |
| Carl Turner | $500 | $500 | R | No |
| Kristy Williams | $500 | $500 | R | No |
| Laura Williams | $500 | $500 | R | No |
| Dan Hawkins | $500 | $500 | R | No |
| JT Rose | $1,000 | $1,000 | R | No |
This investment has paid off in dividends. In June 2024, Kansas awarded Blue Cross Blue Shield, operating under the name “Healthy Blue”, a large Medicaid contract as one of three providers in the state. The new contract is set to run from January 1, 2025, through December 31, 2027, and is worth roughly $4 billion a year across all three companies. Healthy Blue’s share could easily approach $1–2 billion annually after all's said and done.
Because Medicaid managed care contracts are paid in fixed annual amounts, Healthy Blue’s Medicaid revenue is effectively locked in under this agreement regardless of the number of patients. If tens of thousands of Kansans from higher-margin private insurance plans moved to the lower-margin Medicaid program, it would cut into BCBS's overall profitability.
BCBS’s approach to protecting those profits doesn’t end with political spending. In late 2024, Blue KC, the same entity behind Healthy Blue, was sued by AdventHealth Shawnee Mission for allegedly using AI-driven “clinical validation” audits to retroactively deny hundreds of valid physician diagnoses, withholding more than $2 million in payments. Using AI to deny legitimate claims is just another way insurance companies cut corners to protect profits, even when it means denying people the care they need.
The last layer of BCBS's campaign against KanCare expansions is their involvement with the Kansas Chamber. As a cornerstone member of the Kansas Chamber of Commerce, BCBS has a say in the Chamber’s legislative agenda. In 2024, the Chamber rolled out its “Vision 2025” platform, which explicitly includes opposition to expanding Medicaid eligibility.
Chamber Vice President Eric Stafford made their position crystal clear:
Approximately half of 150,000 people who would benefit from Medicaid expansion in Kansas had some form of private health insurance. It would be imprudent to remove those Kansans from the private marketplace in favor of a government program.
Eric’s framing pretends that the “free market” will take care of those already covered while ignoring the 75,000 Kansans who would remain completely uninsured without expansion. Protecting the private insurance companies from losing customers to a public program is more critical to the Chamber than safeguarding tens of thousands of Kansans without existing healthcare.
This is all a result of decades of turning healthcare into just another market where profits come before people. When the system is built to serve corporate interests, decisions about who gets care will always follow the money, and that means blocking anything that might cut into private insurance profits.
Those who are most affected by this are working-class Kansans and rural communities. Without expansion, low-wage workers are left one injury away from medical debt or bankruptcy. This is beyond a policy debate, barring tens of thousands of Kansans the dignity of medical care is depraved. These are the workers that keep our state running, yet they are denied the healthcare that their work should guarantee.
Groups like the Alliance for a Healthy Kansas have been fighting for expansion for years, sharing stories from impacted Kansas and keeping public pressure on the legislature. But as we know, it will take more than just advocacy to overcome the corporate grip on our healthcare system.
As of now Kansas will likely never see Medicaid expansion under the current balance of power in Topeka. Corporate money and the insurance lobby have too tight a grip on the legislature, and both parties have shown they’ll protect profits before people. Every surrounding state that has expanded Medicaid in recent years, like Missouri, Nebraska, and Oklahoma, did it through a ballot measure, bypassing politicians who refused to act. If Kansans want expansion, they’ll have to force it themselves, because the people writing the checks to lawmakers have no interest in seeing it happen.
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