By Jim McLean
KHI News Service
Gov. Kathleen Sebelius at a Friday press conference urged the Legislature to move forward on health care reform. (Photo courtesy of
Topeka Capital-Journal)
TOPEKA, April 2
Gov. Kathleen Sebelius says passage of a health reform bill authorizing the state to purchase private health insurance for thousands of low-income parents should be among the Legislature”s top remaining priorities.
The so-called premium assistance proposal
Senate Bill 387
has been endorsed by a steering committee established by the
Kansas Health Policy Authority
to develop both short and long-term health reform plans for the Legislature.
Calling the proposal and other initiatives endorsed by the Health for All Kansans Steering Committee “a wise plan for this year,” Sebelius said it would be a “huge mistake” for legislators to adjourn the 2007 in April without approving it.
“There has been no real progress addressing our health care crisis,” Sebelius said.
The Senate on Monday tentatively approved the premium assistance bill. The House
is yet to consider it.
Under the premium assistance plan, the state would in fiscal year 2009 purchase health insurance for an additional 8,500 Kansas parents earning up to 50 percent of the
federal poverty level
, about $10,325 for a family of four. The cost for taking that first step would be about $27 million, with $16 million of that coming from the federal government.
The goal of the premium assistance program would be by fiscal year 2011 to cover all parents earning up to 100 percent of the poverty level, about $20,650 for a family of four. Achieving that goal, KHPA officials say, would reduce the number of uninsured Kansans by approximately 10 percent.
At present, almost 300,000 Kansans are thought to lack coverage.
Currently, children in low-income families are eligible for regular Medicaid coverage. But adult eligibility is capped at 37 percent of poverty
about $5,000 a year for a family of two.
“Kansas has one of the lowest eligibility levels in the country,” Marcia Nielsen, executive director of the health policy authority, told legislators last week.
When the premium assistance plan is fully implemented
in fiscal year 2011
the cost will be $77 million, with $46 million of that coming from the federal government.
In addition to seeking approval of the premium assistance program, the health policy authority also has asked for funding to step up its efforts to enroll more children in
HealthWave
, the state program that includes both Medicaid and the State Children”s Health Insurance Program. Currently, about 71 percent of uninsured children are thought to be eligible for the program but not enrolled.
Other short-term reform initiatives endorsed by the health policy authority include a proposal to expand the number of disorders screened for in newborns and funding to support the operations of the Governor”s Health Information Exchange Commission.
Sebelius” proposal to expand Medicaid and SCHIP eligibility to all children up to age five was endorsed by the health policy authority before the session, but faced with criticism from Republican legislative leaders, the steering committee dropped it from its list of consensus recommendations.
Even so, the governor said she remained hopeful the Legislature will approve the $10 million in funding she proposed to finance the expansion.
Long-term reform
Sebelius also is urging lawmakers to approve legislation this year charging the health policy authority with developing a comprehensive reform measure for next year”s Legislature to consider.
The governor said she is open to considering ideas being advocated by Republican leaders in the House that involve seeking flexibility from the federal government to reform Medicare. Concerned about Medicaid”s rising cost, the GOP leaders want to move people off the program and into private coverage.
“Our current system is plagued by the shrinking of private health insurance coverage, and expanding number of Kansans on Medicaid and a stagnant number of uninsured,” House Speaker Melvin Neufeld said recently. “Without clear-cut markets and competition, Kansans will continue to suffer.”
While she is open to market-based proposals, Sebelius said she believes there is a limit to how far policymakers can go in privatizing Medicaid.
“If you look at the group of people who are currently eligible for Medicaid, I think you can make a fairly compelling case that this is not necessarily an ownership group,” Sebelius said. “The likelihood that those Kansans will be negotiating in the private marketplace very successfully I don”t think is a terribly realistic approach.”
A bill developed by House Republicans to set the stage for privatizing Medicaid was pulled from the House debate calendar last week after Nielsen lobbied against it, calling it “too fast, too big and too secret.”
Sebelius said any ideas for the comprehensive reform measure to be presented to the 2008 Legislature should be routed through the health policy authority.
“Let them vet it,” she said.
-Jim McLean is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
jmclean@khi.org
or at 785-233-5443, ext. 110.