Republican and Democratic legislators Wednesday pressured the administration of Gov. Sam Brownback to reconsider plans to seek federal approval of changes in Medicaid services for 400,000 of the state’s disabled and elderly residents.
Senate President Susan Wagle joined three of her Republican colleagues to urge the administration to address fundamental flaws with the privatized medical system, known as KanCare, before moving by January 2019 for what Lt. Gov. Jeff Colyer has touted as KanCare 2.0.
“We must address the problems with KanCare 1.0 before the next steps are taken,” Wagle said. “We firmly believe that mental and behavioral health need to be addressed.”
A joint statement from Wagle, Senate Majority Leader Jim Denning, Senate budget committee chairwoman Carolyn McGinn and Sen. Vicki Schmidt, who chairs the Senate’s health committee, said “there is no certain path forward for KanCare 2.0 at this time.”
“We don’t know how much 2.0 will cost,” said Schmidt, a Topeka Republican irritated the executive branch didn’t respond to accountability requirements adopted by the 2017 Legislature. “There were deadlines.”
The state’s privatized system is supervised by the Kansas Department of Health and Environment and the Kansas Department for Aging and Disability Services, but operated by three for-profit insurance companies — Amerigroup, Sunflower and UnitedHealthcare. Changes to the Medicaid system in Kansas require federal approval.
The Legislature’s KanCare oversight committee, however, has urged the Brownback administration to move ahead with the updated version of KanCare.
Colyer, a physician seeking the GOP nomination for governor, said KanCare had evolved into a model of reform for other states and an approach “leading the country with innovating changes to traditional Medicaid.”
Colyer wants KanCare 2.0 to include a work requirement for some people receiving Medicaid services. It would feature lifetime caps on benefits that reflect state law on distribution of money to the poor under the Temporary Assistance to Needy Families.
“KanCare 2.0 will have improved care coordination for members and simplified billing requirements for providers, which means we can help more people achieve better health with less unnecessary and time-consuming red tape,” Colyer said.
Sen. Laura Kelly, D-Topeka, and House Minority Leader Jim Ward, D-Wichita, said they had enough evidence to indicate Kansas had no business jumping ahead with another incarnation of KanCare. Both are campaigning for the Democratic nomination for governor and agreed the administration ought to wait until 2019 before requesting federal approval for a KanCare 2.0, which would delay implementation until 2020.
“This will allow time to fix ongoing problems and allow the new administration to provide input into a system for which it will ultimately be responsible,” she said.
Sean Gatewood, who represents KanCare Advocates Network, said implementation of the original KanCare system was rushed in 2013. A postponement of the redesign until 2020 will be prudent, he said.
“We learned the hard way that to be successful KanCare must have robust and ongoing stakeholder input, adequate agency resources and a solid, detailed plan,” he said. “We risk the health, safety and quality of life of the nearly 400,000 Kansans who depend upon KanCare if we again try to meet arbitrary deadlines without a well-developed plan that is adequately funded and staffed.”