Gov. Sam Brownback on Friday announced that federal officials have approved a waiver request to implement sweeping changes to the Kansas Medicaid system.

Gov. Sam Brownback announces federal approval to go ahead with KanCare. Kansas Department for Aging and Disability Services Shawn Sullivan is beside Brownback. by Scott Rothschild

Kansas has already awarded three contracts to managed care organizations to run the Medicaid program, which provides health care coverage to 380,000 poor and disabled residents.

Known as KanCare, the Brownback administration has said the changes will help control care costs and improve care.

The new system will be in effect Jan. 1.

In a split vote along party lines, a legislative committee on Thursday rejected pleas from advocates for the elderly and those with disabilities for a delay in implementation of Gov. Sam Brownback's plan to privatize the Medicaid program, which serves nearly 400,000 Kansans.

State Rep. Barbara Ballard, D-Lawrence, sought to delay the proposed Jan.1 startup of KanCare by six months to July 1. "I'm still not convinced that they are ready," Ballard said.

But Republicans on the committee said the state has devoted a lot of time and effort to starting KanCare on Jan. 1 and pushing that back would cause confusion.

"To move that date now would be very inappropriate," said state Rep. David Crum, R-Augusta, who is chairman of the House-Senate Committee on Home and Community Based Services.

Ballard's motion to delay implementation failed 2-3. Joining Ballard was state Rep. Jerry Henry, D-Cummings. Voting against Ballard's motion were Crum, state Sen. Carolyn McGinn, R-Sedgwick, and state Rep. Peggy Mast, R-Emporia.

Under KanCare, the state's current Medicaid system will be switched over to three managed care plans run by private insurance companies. Medicaid is a nearly $3 billion per year state and federally funded program that provides health care to poor and disabled Kansans. The changes must be approved by the federal Centers for Medicare and Medicaid Services before it can be implemented, and the Brownback administration has been shooting for Jan. 1 approval.

Earlier Thursday, advocates for those with disabilities, children and the elderly said that the switchover in 54 days was too fast.

"We believe such an aggressive timeline, with little oversight, for an untested system will place many of the state's frailest and most vulnerable residents into a long-term managed care program that we believe the state is not ready to operate," said David Wilson, the immediate past president and current lead volunteer for AARP Kansas.

Tom Laing, executive director of InterHab, which advocates for those with disabilities, said "We are deeply concerned over the evident lack of preparations to oversee a program of such magnitude."

But Kari Bruffett, director of the Health Care Finance Division of the Kansas Department of Health and Environment, said the state was on track.

Bruffett said state officials had "positive and productive meetings with CMS officials" on Oct. 18.

And she said the managed care organizations were ready to deliver Medicaid services.

The Brownback administration has said KanCare will improve health outcomes while saving the state money.