Kansas: Attempts to Enact Comprehensive Health Reforms Face Obstacles
In May, Governor Kathleen Sebelius signed into law a health care reform bill (S.B. 81) that will lead to modest gains in access to health care and delivery system reform. The law expands SCHIP eligibility for children in households with income up to 225 percent FPL beginning in 2009, and to 250 percent FPL by 2010—once federal funding becomes available—from the current level of 200 percent FPL. In addition, the law allocates $460,000 to expand eligibility for pregnant Medicaid enrollees, $2.5 million to increase funding for safety net clinics, and $1.5 million for the Wichita Center for Graduate Medical Education to fund rural rotations by physicians receiving specialized training in Wichita.
Under a 2007 legislative charge, the Kansas Health Policy Authority (KHPA) proposed a 21-item health reform package with the goals of prevention, personal responsibility, and providing and protecting affordable health insurance. The legislature scaled back the original, comprehensive health reform package, leaving in place nine of the original policy recommendations as follows:
- Incorporating the medical home model of delivery into Medicaid, SCHIP, MediKan (a program covering the disabled before the receipt of federal disability payments), and the State Employee Health Benefits Plan while directing KHPA to develop systems and standards for implementing and administering a medical home by February 1, 2009;
- Moving the Small Business Grant Program (created to help small businesses establish Section 125 plans) from the Department of Commerce to KHPA
- Standardizing insurance cards for Medicaid enrollees;
- Expanding the Community Health Record pilot project, which incorporates claims data into patient electronic records;
- Expanding HealthWave (Kansas SCHIP) outreach in order to enroll more eligible but non-enrolled children;
- Funding continuation of the Coordinated School Health Program with $500,000 to continue bringing educational and community resources into schools to help with health education;
- Adding the Commissioner of Education to the KHPA Board as a non-voting ex officio member as KHPA expands the Coordinated School Health Program;
- Providing dental coverage for pregnant Medicaid enrollees; and
- Providing tobacco cessation counseling services for pregnant Medicaid enrollees.[i]
In the end, out of these nine reforms, the legislature funded only one—continuation of the Coordinated School Health Program. Accordingly, KHPA Executive Director Marcia Nielsen stated that the goal of comprehensive health reform “is a multiyear effort and the important debate about reform in Kansas has begun.” She explained that “funding for health reform is a smart investment” and that “legislators will need to hear the voices of Kansas health care providers, patients, consumers and businesses” if Kansas is to achieve comprehensive health reform.[ii]
Over the next year, KHPA will focus on securing legislative approval for several health reform recommendations, including a statewide smoking ban, an increase in the tobacco products tax from $0.50 to $1.29 per pack of cigarettes, and an expansion of Medicaid for parents and caretakers up to 100 percent FPL.[iii]
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[i] “Sebelius Remains Committed to Schools, Health Care, Openness in Government,” Office of Kansas Governor Kathleen Sebelius, press release, May 19, 2008.
[ii] “Kansas Health Reform: Hard Work Still Ahead,” Kansas Health Policy Authority, press release, May 4, 2008.
[iii] “KHPA Board Retreat Summary,” Kansas Health Policy Authority, press release, June 18, 2008.
