A push by the Brownback administration to keep turning to private firms to run its Medicaid program for years to come faces resistance from key Republican lawmakers.
Those legislators have signaled they want existing problems with KanCare repaired — particularly application backlogs, delays in provider payments and disputes over services for Kansans with disabilities. Only then should the state go ahead with Gov. Sam Brownback’s administration launches what it calls KanCare 2.0 and its new lifetime limits, work requirements and other policy changes. Some also want more information about the cost of those changes.
The same lawmakers who last week criticized Gov. Sam Brownback’s budget proposal for lacking specifics on how to pump more money into schools now say his plan to renew KanCare needs work. The program, started in 2013, pays three private companies billions of dollars to manage the state Medicaid program.
Four top Republicans in the Kansas Legislature last week joined in a statement declaring they “were hesitant to move forward” with KanCare 2.0. The group included Kansas Senate President Susan Wagle and said the health care plan for the poor and disabled still needs to fix administrative and service delivery problems.
“We believe there is still work to do to stabilize KanCare 1.0 and that there is no certain path forward for KanCare 2.0 at this time,” the senators said.
The group also includes Majority Leader Jim Denning, Ways and Means Committee Chair Carolyn McGinn and Public Health and Welfare Committee Chair Vicki Schmidt.
Democrats registered their opposition to KanCare 2.0 months ago. Now the party that controls the Legislature is challenging Brownback, too.
The administration, led by Lt. Gov. Jeff Colyer, a physician campaigning to succeed Brownback as governor, wants federal approval to renew KanCare for another four years, effective Jan. 1, 2019, just days before a new governor takes office.
A plan submitted in late December to the federal Centers for Medicare and Medicaid Services also proposes changes — a work requirement and lifetime cap on benefits for some low-income recipients — that opponents say would further restrict eligibility for the health care program.
They say the plan doesn’t adequately address problems with the existing program that have triggered complaints from patients and providers alike.
“We risk the health, safety and quality of life of the more than 400,000 Kansans who depend on KanCare if we again try to meet arbitrary deadlines without a well-developed plan that is adequately funded and staffed,” said Sean Gatewood, a former Democratic legislator who now heads the KanCare Advocacy Network.
Colyer argues that simplified billing requirements and “improved care coordination” in KanCare 2.0 will “help more people achieve better health with less unnecessary and time-consuming red tape.”
Some lawmakers say KanCare 2.0 also comes with an uncertain price tag. The administration has been reluctant to put a firm cost on the proposed changes, but one key legislator said he believes it could cost an added $100 million a year.
“That kind of gives you pause,” said Rep. Dan Hawkins, a Wichita Republican who chairs the House Health and Human Services Committee. Until recently, he recently supported the administration’s timetable but now favors “more study” of the proposal.
The Brownback administration doesn’t need the Legislature’s approval to implement KanCare 2.0. But, Hawkins said, legislators could stop the administration from moving forward by passing a bill with enough votes to override a Brownback veto.
“That’s certainly a possibility,” Hawkins said.
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.