Praeger briefs KHPA on federal health insurance reform’s effects on Kansas, prospects

Trims in Medicaid expenses proposed

Topeka — The board of the Kansas Health Policy Authority on Tuesday endorsed several measures aimed at reducing Medicaid expenses by $2 million.

The KHPA board also appointed Nicholas Kramer to the position of inspector general, which investigates potential fraud and abuse in the Kansas Medicaid program. Since 1983, Kramer has been the internal audit manager at the Kansas Department of Revenue.

On the budget, the board made recommendations to level Medicaid reimbursement rates for physician services, streamline prior authorization for prescription drugs and implement management controls over prescription mental health drugs.

The proposals will be forwarded to Gov. Mark Parkinson and the Legislature.

Topeka ? Kansas Insurance Commissioner Sandy Praeger on Tuesday gave better than even odds that Congress and President Obama will adopt health reform legislation.

“I think it’s better than 50-50,” said Praeger, who has been in the thick of health insurance issues for years as a former legislator from Lawrence, insurance commissioner and former president of the National Association of Insurance Commissioners.

Praeger, a member of the Kansas Health Policy Authority board, gave board members an update on health reform efforts in Congress. She also serves as chair of an NAIC committee that deals with Congress on the issue.

“It has been a pretty active and fluid dialogue,” she said of health reform negotiations in Congress.

Despite a sometimes bitter debate, Praeger, a Republican, said agreement seems to be forming between Democrats and some Republicans on several basic principles.

According to Praeger, those principles include:

• Everyone should be covered

• There should be no exclusion of insurance coverage for pre-existing conditions.

• Any requirement to have health insurance will require subsidies to help those who can’t afford coverage.

The issue of whether there will be a public option plan is still up in the air, she said. The problem with a government-run public option plan, she said, is that if the plan isn’t required to abide by the same financial rules as private insurance, then it would have an unfair advantage.

She said probably the most viable plan was being crafted by the so-called `Gang of Six,’ which includes three Democrats and three Republicans on the Senate Finance Committee. She said Democrats are trying to make the plan more palatable to Republicans by offering to consider tort reform.

Bottom line, Praeger said, is that health reform is needed.

“I don’t think anybody with a heart or soul can support the position that if you don’t have money you don’t get health care,” she said.

She said the argument that those without insurance can be treated in hospital emergency rooms, doesn’t wash because it forces people to wait until they are more sick before getting treatment. And, she said, it is more expensive than providing earlier care.

Andrew Allison, executive director of the KHPA, said the congressional debate has left state policymakers in Kansas and other states waiting.

“We are paused,” he said. He said if the reforms are approved, then states will have to scramble to enact operational changes. And if the reforms fail, many of the policy issues will fall back to states to resolve.