The first weeks of the legislative session are a time for lawmakers to put forward their favorite ideas that have little chance of becoming law. In most years, that list would include changes to Medicaid, but things are different with the 2017 Kansas Legislature.
Before the Legislature took its midsession break last week, the House passed a bill to expand eligibility for KanCare, the state’s privately managed Medicaid program. Another bill, which would require the three insurance companies that run KanCare to use standardized business processes, remains alive in the Senate.
Legislators returned to Topeka on Monday to resume the session, and it isn’t clear how much farther Medicaid expansion will get.
Previous attempts to expand KanCare eligibility died in committee, and the expansion bill initially had the same fate when the House Health and Human Services committee voted Feb. 20 to table it. But the expansion proposal made a surprise comeback when supporters merged it with another bill and pushed it through the House and Senate.
Sen. Laura Kelly, a Topeka Democrat who serves on the Senate Public Health and Welfare Committee, said she expects that committee will advance the bill but isn’t sure if that chamber’s leadership will bring it to a floor vote.
And if a bill were to gain Senate approval, it could face a veto from Gov. Sam Brownback, who long has said that he doesn’t support expanding KanCare eligibility.
While Medicaid expansion is far from certain, lawmakers have put forward several other bills to change how KanCare runs. Senate Bill 69, which would require the state to come up with standard business procedures for the three KanCare insurance companies, is still alive after Senate leadership sent it to an exempt committee, allowing it to skirt the deadline.
House Bill 2047, which would transfer a KanCare inspector general from the Kansas Department of Health and Environment to the Attorney General’s Office, also went to an exempt committee, giving it an extended lease on life. The inspector general — a position that has been vacant for nearly three years — investigates waste and fraud in the KanCare program that launched in 2013.
Rep. Dan Hawkins, a Republican from Wichita who is chairman of the House Health and Human Services Committee, said he thinks the KanCare inspector general bill has a good chance of getting a vote in the House although some legislators may balk at the $450,000 price tag. The extra funds would raise the inspector general’s salary from the $60,000 KDHE now offers and pay for support staff, he said.
Rep. Susan Concannon, a Beloit Republican who also serves on the House health committee, said the House is taking “baby steps” toward revamping the inspector general’s office. She agreed with Hawkins that a challenging budget year makes the proposal a tougher sell.
“I think it has momentum still,” she said. “There’s still a lot of conversation about that, (but) anything that has a fiscal note is cringeworthy.”
Kelly noted that federal officials have cited problems with KanCare services for people with disabilities, and the Legislature includes more moderate Republicans and Democrats than it did in recent years. Both of those factors are contributing to a desire to change the Medicaid program, she said.
“The time is really ripe for all of this,” she said. “We have been running pretty willy-nilly since we went to privatization in ’13.”
Reform Bills Stall
Other KanCare bills appear to be dead, but supporters could attempt to revive them by combining them with another bill. They include:
- Senate Bill 153, which would require the three insurance companies running KanCare to pay for targeted case management for people with disabilities who receive home and community-based services. That would include assessing the recipients’ needs, developing service plans, referring recipients for supports and following up.
- Senate Bill 160, which would create an ombudsman position for KanCare home and community-based services. The ombudsman would be independent of any state agency and responsible for advocating on behalf of KanCare enrolees who are denied services.
Kelly said she anticipates senators will try to amend bills or use other tactics to advance these changes. Targeted case management has particularly strong support, she said.
“I can guarantee that on the Senate side, we will be looking for a way to move those forward,” she said.
Still A Chance
Health policy issues that didn’t involve KanCare also gained attention in the first part of the session. Those that passed one chamber, meaning they still have a chance of becoming law, include:
- Senate Bill 32, which would allow medical students studying psychiatry to use a state loan assistance program.
- Senate Bill 68, which would allow hospitalized patients to designate a lay caregiver.
- House Bill 2031, which would form a committee to advise the state on palliative care.
- House Bill 2217, which would task the Kansas Board of Pharmacy with developing statewide protocols for use of drugs that treat emergency opioid overdoses.
- House Bill 2205, which would require Kansas schoolchildren be vaccinated against meningitis at age 11 and receive a booster shot at 16, in line with recommendations from the U.S. Centers for Disease Control and Prevention.
- House Bill 2240, which would allow crisis centers for mental illness or substance abuse treatment to accept patients committed to their care involuntarily for up to 72 hours.
- House Bill 2219, which would instruct KDHE to perform an analysis that determines what diabetes is costing the state and what financial benefit could come from preventing and controlling the condition.
- House Bill 2304, which would expand requirements for safe sleeping environments for infants at child care centers.
- House Bill 2107, which would set rules for pharmacies to dispense biosimilars that the U.S. Food and Drug Administration considers interchangeable with brand-name biological medications.
Meg Wingerter is a reporter for KMUW’s Kansas News Service, a collaboration of KMUW, Kansas Public Radio and KCUR covering health, education and politics in Kansas. You can reach her on Twitter @MegWingerter.