Topeka Legislators sent Gov. Kathleen Sebelius health care legislation that supporters say provides greater access to health care for many Kansans and saves them money on insurance.
But Sebelius doesn't think it goes far enough.
The House passed the bill Saturday, 104-16. It then cleared the Senate on a 34-1 vote, with Senate Minority Leader Anthony Hensley casting the lone dissenting vote.
The Kansas Health Policy Authority offered a 21-point plan that called for phasing in a $300 million increase in health care spending over five years and helping to pay for it with a 50-cent increase in the tax on a pack of cigarettes. It also called for a statewide smoking ban.
Neither the tax hike nor the smoking ban got anywhere. The bill Sebelius got was a far cry from the authority's proposal, which she endorsed.
"It's been kind of a downhill conversation of trying to do something under the title of health reform but not moving any substantive legislation," she told reporters.
She added: "We're down to a campaign card that said, 'I voted for health reform in 2008.' Hopefully no one will ask them what it does for them."
Even though she had hoped for more, Sebelius said the bill "probably makes a couple of steps forward."
Rep. Brenda Landwehr, the House's chief negotiator, said the bill makes some improvements in health care. She estimated it would increase spending on health care programs by about $6 million.
"Prevention promotes healthier people, which saves money," said the Wichita Republican. "You can't get everything overnight."
Rep. Jeff Colyer, a surgeon, said the authority's recommendations did nothing to make health care more affordable.
"We made sure the most important health reform is to make health insurance cheaper and allow Kansans to keep their insurance when they get sick or lose their job," said the Overland Park Republican.
Hensley, a Topeka Democrat, characterized the bill as "a list of hollow promises."
Some legislators worried there won't be enough money to pay for what's included in the compromise. Senate Ways and Means Committee Chairman Dwayne Umbarger, a Thayer Republican, said there will be, although the spending will cut into the state's cash reserves.
The compromise also expanded state-paid medical coverage for children changing eligibility requirements from a household income of $42,400 for a family of four to $53,000. Medicaid coverage for pregnant women would go from those with a maximum income of about $15,000 to around $21,000 and provide dental coverage for them.
It also expands cancer screenings at rural health clinics or safety net clinics that treat people without health insurance.
The compromise also repeals a law enacted last year to provide state aid for poor families. Children in such families are covered by the state, but many of their parents aren't.
Some lawmakers didn't realize the program would cost $111 million a year when fully phased in by 2013.
Supporters said the trade-off was expanding the coverage for children.
A key provision requires employers to offer workers leaving their jobs 18 months of coverage if the workers pick up the entire report. Because of state law, thousands of workers lose that coverage after six months.
Many Kansans will be able to save from 15 percent to 40 percent on their health insurance costs with a tax deduction added by the bill.
Sen. Roger Reitz, a physician, said improving health care means spending more money.
"People think we can do this," said the Manhattan Republican, "by grinding out the dollars in the basement."