Gov. Jeff Colyer said Monday that he was not surprised by an announcement from federal Medicaid officials earlier in the day that they would not approve the state's request to impose a three-year lifetime limit on eligibility in the state's privatized Medicaid program known as KanCare.
Colyer's office announced Monday that the Centers for Medicare and Medicaid Services, or CMS, had notified the state's Medicaid director, Jon Hamdorf, of the decision.
CMS Administrator Seema Verma also announced it nationally in a speech to the American Hospital Association in Washington.
The lifetime cap on Medicaid eligibility for working age, nondisabled adults had been part of Colyer's plan to redesign the state's program into what he had been calling KanCare 2.0.
Speaking in Lawrence Monday, Colyer said the state had already been told the request was likely to be rejected, and so the request was withdrawn about two weeks ago.
"On the lifetime caps, there’s a question of whether or not they could do it," he told the Journal-World following a speech to the Lawrence chamber of commerce. "So we were one of several states that applied early on. They came back to us a couple of weeks ago and said no, they cannot do that under federal law."
Colyer was the chief architect of the KanCare system, which took effect in 2013 while he was serving as lieutenant governor under former Gov. Sam Brownback. Under the program, the health benefits of some 400,000 Medicaid enrollees in Kansas are managed by three for-profit insurance companies, known as managed-care organizations.
Those contracts are set to expire at the end of this year, and the administration had planned to solicit new requests for proposals in order to launch KanCare 2.0 in January.
But Kansas lawmakers put a hold on that in the budget bill they just adopted last week by inserting language saying the administration could continue negotiating with CMS over other eligibility issues, including a proposal to enact work requirements for working age adults who are not disabled. But the administration cannot make any substantive changes in eligibility requirements without prior legislative approval.
Colyer said he still intends to move forward on those talks with CMS.
"We’re still looking at work opportunities," Colyer said. "This is a normal process issue. It doesn’t change where we’re going. That (the lifetime cap) was an important piece that we thought would help us in the long run, and the federal government just can’t do it."
Meanwhile, health care advocates in Kansas applauded CMS's decision.
Sheldon Weisgrau, interim executive director of the Alliance for a Healthy Kansas, said in a statement that the three-year lifetime cap "would have done severe damage to the program's ability to act as safety net for the most vulnerable Kansans."
And Hilary Gee, a lobbyist for the American Cancer Society Cancer Action Network said in a statement that the limit, "would have been particularly threatening to cancer patients and survivors, who require regular treatment and uninterrupted health care access."
During his speech to the Lawrence chamber, Colyer reiterated his opposition to expanding KanCare under the Affordable Care Act, which would extend coverage to an estimated 150,000 additional individuals. He also predicted that Congress will make another attempt this year to repeal the ACA, also known as Obamacare.
"I do expect the federal government to have another run at health care reform in this next year," he said in response to a question from the audience. "I think that will probably tell us where the system is headed in a lot of ways."
In response to other questions Monday, Colyer said he and his staff are just starting to review the new spending bill lawmakers approved last week, and he has not yet decided whether he will exercise his line-item veto authority on any items.
"There were 220 different budget compromises that were made, so we’re just in the first stages of evaluating those," he told the Journal-World.
He also declined to comment directly on the recent news that former University of Kansas Chancellor Bernadette Gray-Little was still being paid over $510,000 in salary and benefits to serve as a special adviser to the university following her stepping down as chancellor last year.
"I understand you need transitions," he said. "It’s really going to be up to the Board of Regents. They are the ones that control that. Hopefully they will learn some lessons."