Gov. Sam Brownback and his administration have come up with a plan they say will improve care and reduce costs for Medicaid recipients in the state. That’s a good goal, but questions being raised about the plan indicate that the state needs to iron out more of the details before rushing ahead with a plan that will affect about 380,000 vulnerable Kansans.

The governor’s office says there’s no need to delay the scheduled Jan. 1, 2013, implementation date for the new plan because the administration already has been working on the plan for more than a year. State officials also say they have been talking to people across the state about the plan, but it’s not clear to whom they were talking. Since the plan was released to the public about two months ago, various stakeholders have raised many questions and concerns, but state officials have shown no willingness to revise or slow their plan based on what they are hearing.

A major area of concern in the Medicaid plan is how it will affect Kansans with developmental disabilities. Although advocates say managed care may be a valid way to handle the health care needs of this population, they don’t see how it will work for the other services, such as in-home support, that help preserve clients’ independence.

Despite the concerns voiced by agencies and legislators on both sides of the aisle, the Medicaid effort led by Lt. Gov. Jeff Colyer is moving full speed ahead. Colyer said Tuesday that the state would decide this summer which private insurance companies will manage the new Medicaid program. Fifteen companies qualified to bid on the contract and Colyer said “multiple organizations” had submitted proposals by the Jan. 31 deadline.

Colyer wouldn’t say exactly how many companies applied, but one of them is not Blue Cross and Blue Shield of Kansas, the state’s largest, and arguably most respected, health insurance provider.

During a chat Monday on the Journal-World’s Well Commons website, Secretary of Aging Shawn Sullivan said he wasn’t surprised that Kansas BCBS didn’t submit a bid because Medicaid populations do not “fit within their current business model.” He added that “If you look at the BCBS system across the country, I don’t believe they cover any Medicaid populations or consumers.”

On the contrary, the national BCBS website states: “Blue Cross and Blue Shield Plans partner with states to provide coverage to millions of Medicaid and SCHIP (State Children’s Health Insurance Program) beneficiaries. Collectively, Blue Cross and Blue Shield Plans have always been the single largest provider of managed care services to Medicaid beneficiaries …”

In announcing its decision, BCBS of Kansas said the state plan “would have required us to dramatically change our business model to serve new populations in different settings in less than a year.” Could it be that, despite the fact that BCBS provides managed care services to millions of Medicaid clients in many states, the group just couldn’t get comfortable with the drastic changes being proposed in Kansas, especially on such a short timeline? The BCBS decision not to participate in the new plan raises questions about the quality of care and service that will be provided by successful bidders for the state contracts.

Unfortunately, the Medicaid plan seems to be following a pattern in the Brownback administration of pushing through “reforms” before fully considering the details or consequences of the action. It’s not wrong to look at different ways of doing things, but it’s important to take the time to work through potential problems before making changes that will have a profound impact on thousands of Kansans.