Topeka Kansas would move toward helping needy residents purchase private insurance rather than paying directly for their medical services and nursing home care under a sweeping plan drafted by House Republicans.
But criticism from other legislators and officials led Republican leaders to cancel a House debate Tuesday and send the bill containing the plan to committee. The measure represented the year's major health care initiative from the House's GOP majority.
Speaker Melvin Neufeld said the measure isn't dead for the session and that the Legislature needs to make progress on health care issues this year. But he said too many people were confused about the bill's contents.
"That's the problem," said Neufeld, R-Ingalls. "That's the reason we need to slow down and take a better look."
The bill would overhaul the state's $1.3 billion Medicaid program, which reimburses doctors, clinics, hospitals and others for providing care to some 250,000 poor and disabled Kansans a month.
Marcia Nielsen, executive director of the Kansas Health Policy Authority, an agency formed in 2005 to review health issues and make policy recommendations, called the bill "loosely worded and poorly explained." The authority also administers Medicaid jointly with the federal government.
"It's a mess," she said of the bill during an interview. "It's turning Medicaid on its head, without evidence that it needs to be turned on its head."
Many legislators saw rising medical and health insurance costs as among the most pressing issues they faced when the session began in January. Gov. Kathleen Sebelius also called on them to draft a plan for eventually bringing universal health coverage to Kansas.
Like other legislators, House Republicans say their goals are to give needy Kansans more choices about their health care, reduce the number of uninsured Kansans, make the health insurance market more competitive and control costs for consumers and the state.
But Republicans have resisted Sebelius' call for universal coverage because many worry about expanding state government's reach.
"We need to make health care more affordable for all Kansans - the commercial side," said Rep. Jeff Colyer, R-Overland Park, a doctor who led the GOP task force drafting the plan. "We need to reform Medicaid."
He added: "We need to work on a transition from Medicaid and the uninsured into more stable, private insurance, and we need to do some things for the uninsured."
But the authority complained that the House Republicans' plan would require it to conduct 10 studies, establish four pilot programs and file nine requests with federal officials for them to waive rules governing Medicaid, which is funded and administered jointly by states and federal government.
And Nielsen questioned whether turning to the private market could help some of the targeted Kansans. For example, the bill sets a goal of phasing out Medicaid payments for Kansans' nursing home care and replacing them with long-term care insurance coverage in five years.
"People who are already in long-term care facilities couldn't possibly find a private long-term care insurance provider," she said. "If they could, there's no way that it would be affordable."
House Minority Leader Dennis McKinney said Kansans on Medicaid or without insurance aren't in the health insurance market because companies don't believe insuring them is profitable.
"The only way you get a plan adopted and start making meaningful changes is when you have bipartisan buy-in and you work with all the stakeholders," said McKinney, D-Greensburg. "That did not happen on this bill."