JIM SALTER, Associated Press

WELDON SPRING, Mo. (AP) — Missouri Gov. Jay Nixon says law enforcement officials have been working around the clock to make sure residents and businesses will be kept safe once prosecutors announce whether a suburban St. Louis police officer will face charges for fatally shooting 18-year-old Michael Brown.

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WELDON SPRING, Mo. (AP) — Missouri Gov. Jay Nixon plans to outline law enforcement plans as the St. Louis region prepares for the grand jury announcement in the Michael Brown case.

Nixon and law enforcement leaders are expected to speak at a Tuesday news conference at Missouri State Highway Patrol Troop C headquarters in suburban St. Louis.

The unarmed black 18-year-old Brown was shot and killed by white Ferguson police officer Darren Wilson on Aug. 9. The shooting led to significant unrest in Ferguson and throughout the St. Louis area, and there is concern protests will escalate after the announcement. The grand jury is deciding if Wilson will face charges.

St. Louis County prosecutor Bob McCulloch said Monday that the grand jury still is meeting and a decision is expected this month.

DONNA CASSATA, Associated Press

WASHINGTON (AP) — Soft-spoken Republican Sen. Susan Collins is quite popular these days, fielding calls from President Barack Obama, members of the GOP leadership and top Senate Democrats Harry Reid and Chuck Schumer.

The outreach was more than just congratulations for winning a fourth term. Both parties have an incentive for courting Collins.

Come January, the centrist from Maine will be a crucial member of a group of moderates wielding considerable clout in the Republican-led Senate.

The GOP likely will hold 54 seats next year, six short of the 60 necessary to break Democratic delaying tactics. Incoming Majority Leader Mitch McConnell would need the support of Maine’s independent Angus King and Democrats such as North Dakota’s Heidi Heitkamp, West Virginia’s Joe Manchin, Indiana’s Joe Donnelly and Jon Tester of Montana.

SEDALIA (AP) – Pettis County authorities said two people are charged with kidnapping a woman in Sedalia, taking her to Kansas City and holding her in hotels for two days before she escaped.

Court documents say 27-year-old Joseph Rankin and 45-year-old Paula Hopkins were both charged Monday with felonious restraint and armed criminal action. They are being held at the Pettis County Jail on $500,000 bond.

The Sedalia Democrat reported court documents indicate the woman was kidnapped Oct. 31 from her home. She was then driven to the Kansas City area, where she was allegedly forced to write several checks and withdrawals were made from her account.

The woman said she was held at two Kansas City-area motels before she escaped by jumping from a moving car in Kansas City, Kansas.

By Jim McLean
KHI News Service

TOPEKA — Kansas hospitals are moving ahead with plans to put a Medicaid expansion plan before lawmakers despite election results that returned Gov. Sam Brownback to office and solidified conservatives’ control of the Legislature.

Democrat Paul Davis favored expansion but came up short in his bid to upset Brownback, a Republican who thus far has opposed expansion. Also, several Democratic House members who likely would have favored expansion lost narrowly to GOP challengers.

Similar results across the country prompted national observers to declare expansion unlikely in Kansas and four other states where candidates who opposed expansion won close governor’s races.

“No one would say it was a good night for the prospects of Medicaid expansion,” Joan Alker, director of the Center for Children and Families at Georgetown University, told Kaiser Health News.

Twenty-eight states and the District of Columbia have expanded Medicaid eligibility, while Kansas and 20 other states have not. Policymakers in two states are considering the issue, according to the nonpartisan Kaiser Family Foundation.

Signals sent

When talking to reporters on election night, Brownback gave no indication that he had changed his mind on Medicaid expansion.

“If you’re talking about Obamacare,” he said, “we’ll look at things another day for that.”

Tom Bell, CEO of the 136-member Kansas Hospital Association, didn’t expect an immediate change of heart. But now that the election is over, Bell said, he has reason to believe the Brownback administration and some legislative leaders will be more open to discussing expansion.

“Yes, we’ve had folks in the administration that have indicated that after the election this would be a different kind of discussion,” Bell said. “And we’re counting on that. We certainly plan to move forward.”

In Missouri, Sen. Ryan Silvey also intends to press ahead. The Kansas City Republican said “more and more people are coming to the realization” that expansion is needed to protect hospitals.

“It’s going to be damaging to our hospitals if we don’t do something,” Silvey said in late October.

Under the Affordable Care Act, disproportionate share hospital funds, which the federal government pays to health care providers to offset the costs of charity care, will be phased out starting Oct. 1, 2015. When the law was written, it was assumed hospitals would no longer need the disproportionate share hospital payments because millions of previously uninsured Americans would have either subsidized private coverage or Medicaid.

A study published in August by the nonpartisan Urban Institute said that not expanding Medicaid would cost Kansas and Missouri hospitals more than $9 billion in federal funding over a 10-year period. Losses would total $2.6 billion in Kansas and $6.8 billion in Missouri from 2013 to 2022, the report said.

The health reform law requires the federal government to shoulder all Medicaid expansion costs for three years. After that, the federal share will gradually decline until it reaches 90 percent, where it will remain.

About 300,000 low-income Missourians would gain coverage under expansion. In Kansas, expansion would extend coverage to an estimated 151,000 people with annual incomes up to 138 percent of poverty – $16,104 for individuals and $32,913 for a family of four.

Missouri lawmakers were close to striking a deal on Medicaid expansion last spring at the end of their regular session. Silvey has said the retirement of some the lawmakers who blocked the deal may help him gain approval of a compromise proposal in the upcoming session.

A Kansas plan

The Kansas Hospital Association has been working for months on an expansion plan that will be unique to the state, Bell said. Like plans crafted in states headed by Republican governors opposed to the ACA, the Kansas proposal likely will call for subsidizing the purchase of private insurance for those made eligible by expansion. And it will be tailored to work with KanCare, the state’s already privatized Medicaid system, he said.

“We have a private program right now,” he said. “It is being administered by private insurance companies. It just seems to us that we ought to build on that.”

Recognizing that the state’s growing budget problems loom as an obstacle to expansion, Bell said the KHA proposal will include a funding mechanism to lessen its cost to taxpayers. Funding options under consideration include raising a state assessment on hospitals. The state uses the assessment to bolster Medicaid rates paid to hospitals. That, in turn, triggers an increase in federal matching funds.

Expanding Medicaid eligibility would increase the amount generated by the assessment because of the higher federal match rate. But raising the assessment rate also is a possibility. Currently, hospitals pay assessments equal to 1.83 percent of their revenue. Federal law allows for assessments of up to 6 percent.

Good timing

A possible upside to the election results is that the Republican takeover of the U.S. Senate could motivate Obama administration officials to be more flexible when negotiating with states, Bell said. It could make them more open to Medicaid expansion proposals designed to appeal to conservatives that include elements such as work requirements and higher copays and deductibles.

Wyoming officials also appear to be banking on that. Just a few days after the election, Republican Gov. Matt Mead said he was moving forward with a Medicaid expansion plan tailored to the “needs” of the Cowboy state.

“Some of the areas we’re looking at is people who are on the program, that they have some of their own, as it’s said, ‘skin in the game,’” Mead said in the Casper Star-Tribune. “In other words, they would pay a portion of the premium; they would pay a portion of the deductible. There would be a workforce development plan involved in it. And those types of things, I think (federal officials) are more open to than they were a year ago, and certainly more than two years ago.”

Jim McLean is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

ST. LOUIS (AP) – Attorneys for a Missouri man scheduled to be executed next week have asked Gov. Jay Nixon to grant clemency, citing concerns about the role race played in Leon Taylor’s death sentence.

The state plans to execute Taylor at 12:01 a.m. Wednesday for killing an Independence gas station attendant in 1994. He would be the ninth man put to death in Missouri this year and the 11th since November 2013.

Attorneys for Taylor said his sentence should be commuted to life in prison without parole, saying Taylor, who is black, was sentenced by an all-white jury. They also raise concern about prosecutor misconduct during his trial.

OMAHA, Neb. (AP) — The Omaha Archdiocese has announced that a priest has died in a traffic accident while vacationing in Branson, Missouri.

The archdiocese chancellor, Tim McNeil, says the Rev. Francis “Frank” Partusch was struck by a car and killed. A Branson police news release says the accident occurred a little before 5 p.m. Monday on Missouri Highway 76 on the west side of Branson. The accident cause is being investigated.

Archbishop George Lucas says Partusch’s death “is a tragic loss for his family, parishioners and his brother priests.”

The 68-year-old Partusch had been pastor of St. Bridget-St. Rose Parish in south Omaha. He’d previously served at other Omaha parishes and at St. Michael’s in South Sioux City.

TOPEKA, Kan. (AP) — A civil liberties group is drafting a response to an order from U.S. Supreme Court Justice Sonya Sotomayor that blocks gay marriage in Kansas.

Sotomayor put a hold on a federal judge’s ruling that would have allowed same-sex unions in the state starting at 5 p.m. CST Tuesday.

That injunction came in a lawsuit filed last month by the American Civil Liberties Union. Kansas wants to enforce its ban while the lawsuit is reviewed.

Sotomayor directed the ACLU to respond Tuesday. The group expects that to be ready ahead of an afternoon deadline.

Gay rights advocates and state officials say even if Sotomayor clears the way for gay marriages in this case, it’s not clear how it would affect a separate case on the issue before the Kansas Supreme Court.

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TOPEKA, Kan. (AP) — Kansas gay-rights advocates are watching the U.S. Supreme Court as they hope same-sex couples can get marriage licenses this week.

U.S. Supreme Court Justice Sonia Sotomayor on Monday temporarily blocked gay marriages in Kansas, but it wasn’t clear how long she or the high court would continue to do so.

Sotomayor put on hold a federal judge’s injunction preventing the state from enforcing its gay-marriage ban. The lower-court ruling was to take effect at 5 p.m. CST Tuesday.

The judge’s injunction came in a lawsuit filed last month by the American Civil Liberties Union. Kansas wants to keep enforcing its ban while the lawsuit is reviewed.

Sotomayor directed the ACLU to respond Tuesday.

If the justice reconsiders, gay couples could head to Kansas courthouses Wednesday morning.

CLAYTON, Mo. (AP) — St. Louis County prosecutor Bob McCulloch says the grand jury in the Michael Brown case is still meeting, and he is urging people to ignore what he calls “rank speculation” in social media.

McCulloch put out a statement Monday saying the time frame for a decision in the case is still mid- to late-November. Some reports have suggested specific dates for an announcement on whether charges will be filed against Darren Wilson, the Ferguson officer who shot and killed Brown on Aug. 9, citing alleged leaks of information.

The shooting of Brown led to months of unrest. Many in the St. Louis area are expecting an escalation of protests after the grand jury announcement.