Posts tagged with Medicaid
Topeka — Is Gov. Sam Brownback moving closer to siding with expansion of Medicaid under the federal Affordable Care Act?
In a two-minute question and answer session with reporters, Brownback, a Republican who opposes the ACA, said his administration is looking at options and alternatives.
"We're still working on Medicaid, what we can do that we could make it work," he said.
Brownback then talked about wanting to make sure the state budget was in good shape and that when he took office in 2011, he was facing a shortfall "after the Sebelius administration."
Former Gov. Kathleen Sebelius, a Democrat, left Kansas to become President Barack Obama's secretary of the U.S. Department of Health and Human Services. Sebelius was succeeded by Mark Parkinson, the former lieutenant governor, who had to deal with record revenue shortfalls during the Great Recession. Ironically, it's Sebelius, as HHS secretary, who is working with governors considering Medicaid expansion.
While many Republican governors, including Brownback, have been critical of Medicaid expansion, some are warming to the idea since the federal government will pay for the first three years, and 90 percent of it after that. Some have also said that it would be unwise for a state to leave federal money on the table for other states to take.
Missouri Gov. Jay Nixon, a Democrat, has been trying to persuade Republican legislative leaders to get on board. Earlier this week, Nixon said that if Missouri were to reject expansion of Medicaid it would become like a town from the 1860s that refused a railroad or a city from the 1960s that rejected an interstate highway. In Kansas, estimates indicate that Medicaid expansion would extend coverage to 200,000 more people.
Currently, Medicaid provides health care coverage to about 380,000 Kansans. The largest portion of them — about 230,000 — are children. The rest are mostly lower-income, pregnant women, people with disabilities and elderly people. The $2.8 billion program is funded with federal and state dollars.
Medicaid in Kansas doesn’t cover low-income adults who don’t have children. And a nondisabled adult with children is eligible only if his or her income is below 32 percent of the poverty level, which is less than $6,000 per year. That is about the most difficult eligibility level in the country.
But starting in 2014, the ACA creates an eligibility level of 138 percent of the federal poverty level, which is $15,415 per year for an individual and $31,000 per year for a family of four.
In the Legislature, Senate President Susan Wagle, R-Wichita, has been open to the idea of expanding Medicaid, while House Speaker Ray Merrick, R-Stilwell, hasn't.
Topeka — In Kansas, Gov. Sam Brownback and his conservative Republican colleagues in the Legislature seem to be following the no-way, no-how lead of Texas Gov. Rick Perry on whether to expand Medicaid under the federal Affordable Care Act.
But this story link text in the San Antonio Express-News shows that not all is as it appears in Texas.
While Perry, whom Brownback backed for the Republican nomination for president, is taking a tough-guy stand against Medicaid expansion, key legislators in the Lone Star State are working behind the scenes for a "Texas solution."
And there may be more acceptance in conservative Republican circles for a proposal by Arkansas that has apparently gotten the green light form Health and Human Services Secretary Kathleen Sebelius, a former Kansas governor. This bloglink text reports that Sebelius has said OK to the plan to use Medicaid dollars to buy private insurance.
So far, Brownback says he is undecided on whether to opt in to expanding Medicaid in Kansas, although whenever asked he says he worries about the costs and notes the state's budget problems — problems caused by income tax cuts he signed into law last year.
And conservative Republicans in the Legislature are pushing a resolution opposing the expansion of Medicaid. Hospitals and health care groups oppose the resolution. In addition, a statewide poll conducted on behalf of the Kansas Hospital Association found that 60 percent of Kansans support expanding Medicaid.
Under the Affordable Care Act, the federal government would pay the entire cost of the expansion for three years, and then that share would fall down to 90 percent after that.
Currently, Medicaid provides health care coverage to about 380,000 Kansans. The largest portion of them, about 230,000, are children. The rest are mostly lower-income, pregnant women, people with disabilities and elderly people. The $2.8 billion program is funded with federal and state dollars.
Medicaid in Kansas doesn’t cover low-income adults who don’t have children. And a nondisabled adult with children is eligible only if his or her income is below 32 percent of the poverty level, which is approximately $5,000 per year. That is about the most difficult eligibility level in the country.
But starting in 2014, the ACA creates an eligibility level of 138 percent of the federal poverty level, which is $15,415 per year for an individual and $26,344 per year for a family of three.
Estimates are that expansion would cover upwards of 150,000 more Kansans.
Brownback remains undecided on Medicaid expansion; supports adult stem cell center; declines to state position on drug testing welfare recipients and relaxing renewable energy standards
Topeka — Gov. Sam Brownback on Wednesday said he hasn't made up his mind on whether Kansas should opt in to a federally funded expansion of Medicaid, but he expressed concerns about the future flow of dollars to the state from Washington, D.C.
In a brief question and answer period with reporters as the 2013 legislative session neared the midway point, Brownback said he was still analyzing data on Medicaid expansion but added that he is worried about future costs.
"We have a lot of pressures on the state budget that are significant," he said. He mentioned a court order to increase school funding, an at-capacity prison system and what he described as high demand for spending on public universities.
In addition, Brownback predicted that federal funding to the state in general would decrease over the next decade because of federal budget difficulties.
Under the Affordable Care Act, the feds would pay 100 percent of the Medicaid expansion costs for three years and then ratchet that down to 90 percent over the next several years.
On other issues, Brownback declined to state his position on bills that would relax renewable energy standards and require drug testing of some welfare beneficiaries.
"We'll see what gets to me," he said of a measure approved by a House committee to rollback the requirements for renewable energy.
On a bill approved by a Senate committee that would require drug tests for recipients of certain benefits, Brownback said, "Let's see what the Legislature puts forward on something like that."
Asked to comment on a Senate committee rejection of his reading initiative, he said he understood it was an emotional subject and that the discussion will continue. The Senate Education Committee defeated Brownback's proposal that would have required schools to hold back students in the third grade if they scored in the bottom performance level on the state's reading test.
On another issue, Brownback expressed support for establishing an adult stem cell center at Kansas University Medical Center.
"Having an adult stem cell center is not only highly plausible, it's being done and used in many places around the world," he said. "If Kansas could take a leadership position in that, it could be a highly useful thing for people to get treatments. There are number of different maladies now being treated by noncontroversial stem cell treatments," he said.
He added, "Let's see what develops in the process and in the bill." The bill would prohibit the center from using embryonic stem cells or cells taken from aborted fetal tissue.
Gov. Sam Brownback on Friday announced that federal officials have approved a waiver request to implement sweeping changes to the Kansas Medicaid system.
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.
About 75 people on Friday gathered outside the Statehouse, calling for Gov. Sam Brownback to support an expansion of Medicaid, the state and federally funded program that covers the cost of health care services for nearly 400,000 Kansans, mostly children, pregnant women and those with disabilities.
Rev. Joshua Longbottom, of the Plymouth Congregational Church in Lawrence, was one of several speakers at the rally. He said Jesus would have supported the expansion.
"If Jesus was up in the Capitol, would he make a choice to keep 130,000 people without care," Longbottom asked. The crowd responded "No."
Under the Affordable Care Act, the state has the option to extend Medicaid coverage to include all children and adults under the age of 65 who live at or below 133 percent of the federal poverty level. For a family of four, that is an annual income of $30,657 or less. Extending the Medicaid program in 2014 could help provide access to as many as 130,000 more Kansans, according to the Kansas Health Consumer Coalition.
The federal government would cover of the cost of the Medicaid expansion for the first three years and most of the cost after that.
Republicans and some Democrats have expressed concerns that because of federal budget problems, the federal government may not be able to carry through with its funding commitment.
And Brownback has been an ardent opponent of the Affordable Care Act. Yesterday he announced he would block an effort by Kansas Insurance Commissioner Sandy Praeger for a state-federal partnership in starting a health insurance exchange under the ACA. That means the federal government will have to do it.
Douglas County has sometimes been called an island of blue in a sea or red in Kansas, meaning it votes Democratic while most of the rest of the state votes Republican.
But the blue dot becomes even more noticeable in the Midwest when looking at a national map of county results. There is blue Douglas and Wyandotte, which went for President Barack Obama.
And then there is a sea of red — counties where Republican Mitt Romney secured a majority of votes — that includes all of Oklahoma, all of Nebraska, except for one county, and all of Missouri, except for three counties. Farther south, Texas is mostly red until Dallas County and Travis County and then a belt of blue in South Texas.
Here is a link to the New York Times presidential election map by counties. link text
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.