State Medicaid officials on Friday formally started the process of renewing KanCare, the privatized Medicaid program launched by Republican Gov. Sam Brownback in 2013.
The two state agencies that oversee the private contractors that manage the program released a draft of the plan they intend to submit for federal approval after a public comment period that runs through November.
Susan Mosier, secretary of the Kansas Department of Health and Environment, the state’s primary Medicaid agency, said changes proposed in “KanCare 2.0” are aimed at improving the health of approximately 425,000 low-income, disabled or elderly Kansans enrolled in the program and addressing the administrative and service delivery problems that have plagued it since its launch.
“As we move to KanCare 2.0, we’re really moving from a plan of care to a plan of service,” Mosier said.
That means shifting beyond a focus on medical care to also addressing the social factors that influence the health of individuals and populations, she said. Social determinants of health include education, employment, housing and behaviors.
“We’re talking about really engaging with the individuals we serve and identifying with that individual what is their vision for their own good life,” Mosier said.
The draft plan posted Friday to the KDHE website said the state anticipates “continued savings under the KanCare program” but didn’t specify how much. A specific savings estimate will be included in a final draft submitted to the federal Centers for Medicare and Medicaid Services.
Earlier in the week, Lt. Gov. Jeff Colyer, the primary architect of KanCare, said it had reduced projected increases in Medicaid spending by $1.4 billion over the past five years. He also said that a stakeholder group he formed to address problems in the current program was making progress.
Even so, advocates for KanCare recipients expressed doubts about the capacity of the Brownback administration to deliver the promised improvements in KanCare 2.0.
“I think the goals and the vision are great,” said Sheldon Weisgrau of the Health Reform Resource Project. “But there has really been no evidence in the first five years of KanCare that they are capable of doing the things they say they want to do.”
To buttress his case, Weisgrau said it remains to be seen whether the administration has remedied problems that prompted federal officials to initially deny the state’s request for a one-year extension of the current program to allow more time for the development and implementation of KanCare 2.0.
Federal officials approved the extension earlier this month based on the state’s promise to implement a corrective action plan.
In addition to questioning the administration’s ability to implement KanCare 2.0, advocates are objecting to a proposed change that would require approximately 12,000 non-disabled recipients to work or participate in job training to maintain their benefits. Federal officials have historically rejected such work requirements, but several states are now pursuing them in the belief that the Trump administration will approve them.
The intention of work requirement is “to promote the highest level of member independence,” according the KanCare 2.0 plan.
Non-disabled adults in families receiving cash assistance under the Temporary Assistance for Needy Families, or TANF, program already must comply with the requirement.
Work requirements are “legally questionable,” said David Jordan, director of the Alliance for a Healthy Kansas, a nonprofit lobbying organization primary focused on expanding KanCare eligibility.
“It will reduce access to care,” Jordan said.
Pregnant women, individuals with physical or intellectual disabilities, and low-income parents with children under the age of 6 would be exempt from the requirement.
Jim McLean is managing director of KMUW's Kansas News Service, a collaboration of KMUW, Kansas Public Radio and KCUR covering health, education and politics in Kansas. Follow him on Twitter @jmcleanks.
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