Brownback Dumps KanCare 2.0, Sort Of

Jan 24, 2018

Plans for KanCare 2.0, the proposal to keep management of the state’s Medicaid program in private hands for years to come while adding new eligibility restrictions, halted Wednesday.

At least that’s what Republican Gov. Sam Brownback indicated in a mid-day news release, which said the plan was being scrapped after lawmakers worried about cost increases nearing $100 million a year.

Critics reacted quickly, insisting that the administration’s proposal to extend the current KanCare program by three years while adding some of the same eligibility restrictions included in the 2.0 proposal didn’t amount to much of a retreat by the administration.

In particular, they objected to the administration’s plan to push forward with plans to add a work requirement.

“This requirement would create costly and burdensome administrative red tape for enrollees, providers, and businesses and will still require federal approval,” David Jordan, director of a foundation-funded coalition of health advocates, said in a release.

The recent approval by federal officials of Kentucky’s work requirement has already spawned a lawsuit, Jordan said.

“It is unclear how the administration proposes to pay for these additional administrative burdens and the lengthy and costly legal process likely to follow,” Jordan said. “Rather than confuse and complicate the situation, the administration should officially withdraw KanCare 2.0 (and improve) the current KanCare program.”

The governor’s at-least-partial surrender on the fight came after key lawmakers a week before told the Kansas News Service that problems in KanCare as it already exists need fixing before they’d go along with any effort to lock-in substantial changes in a new program.

KanCare launched in 2013, hiring three private companies to manage the billions the state spends on Medicaid to provide health care to the poor and disabled.

Following objections from top Democrats in the Legislature, Senate President Susan Wagle, Majority Leader Jim Denning and other Republicans publicly signaled their reluctance to back KanCare 2.0.

Their resistance, those Republicans said, came out of frustration with the existing version of KanCare, its backlog of applications and criticism that it shut off people from health coverage that the state intended to cover.

Acknowledging the failure of past efforts to clear the backlog, Brownback said, Jeff Andersen, the newly appointed secretary of the Kansas Department of Health and Environment, is instituting new get-tough measures to deal with the problem.

“The state is in the process of issuing a letter of noncompliance to the contractor in charge of the eligibility clearinghouse where applications are processed,” the release said.

Brownback’s announcement Wednesday also attributed the decision to set aside the KanCare renewal to Lt. Gov. Jeff Colyer. He’s a plastic surgeon and a candidate for governor who led the state’s transition to managed care and saw KanCare 2.0 as a way to preserve his signature policy accomplishment.

The state had been seeking federal approval to renew KanCare for another four years, effective Jan. 1, 2019, just days before a new governor takes office. That request will now be withdrawn so that the state can instead seek approval to extend the current program by three years, Brownback said.

In their news release, Brownback and Colyer said the administration would either extend current contracts with three insurance companies handling Medicaid for Kansas or allow them and the companies who were preparing KanCare 2.0 bids to compete for new contracts.

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Jim McLean is managing director of the Kansas News Service, a collaboration of KMUW, Kansas Public Radio and KCUR covering health, education and politics in Kansas. Follow him on Twitter @jmcleanks.