By Mike Shields
KHI News Service
TOPEKA, March 22
Unswayed by strong and colorful protest from the director of the
Kansas Health Policy Authority, a House appropriations subcommittee on Thursday voted out a 58-page, health-care reform bill that aims to eliminate Medicaid in Kansas as it currently exists.
And because of a procedural move by the subcommittee, what survived for less than 24 hours as
House Bill 2591
will now go straight to the House floor as
Senate Bill 11
. The Senate bill was stripped of its original language, HB 2591 was substituted, and the measure was shipped out on the last day of the panel”s regularly scheduled meetings.
The bill is a lengthy and complex proposal, the writing of which wasn”t complete before late Wednesday afternoon. A hearing on it was hastily called Thursday in the subcommittee chaired by Rep. Bob Bethell, R-Alden. So quickly was the bill turned that only a handful of people had time to read it, let alone give it in-depth analysis.
Among those who protested the speed with which the bill was handled were health policy authority director Marcia Nielsen and two Democratic members of the subcommittee, Reps. Jerry Henry of Cummings and Barbara Ballard of Lawrence.
“I can”t criticize it because I haven”t had time to read it,” Ballard said. “We barely got on the train and it”s moving so fast I can”t even plant my feet.”
At least a couple of people who testified on the bill, including Jerry Slaughter of the Kansas Medical Society, said they hadn”t had time to prepare the written testimony that usually accompanies proposed legislation. Slaughter said the medical society was “vitally interested in reform” but he told members he couldn”t comment specifically on the bill without more time to study it.
Nielsen urged members to vote down the bill, calling it “too fast, too big, too secret,” comparing it to the doomed health care reform plan of President Bill Clinton.
She also called the bill “surprisingly broad and convoluted” and said she was dismayed to have only been made aware of it the night before the committee heard it.
Among other things, she said, the bill asked too much of the fledgling health policy authority, the agency created by the Legislature to study and propose health care policy. It also oversees the state”s Medicaid program and the state employee health plan.
“We can walk and chew gum, swim the backstroke and juggle,” she said. “But we cannot walk, chew gum, swim the backstroke, juggle and do the Macarena at the same time.”
One committee member later asked her what the Macarena was, and Nielsen obligingly demonstrated a couple steps of the once-popular Latin dance. But that failed to turn the committee”s majority who heard Rep. Jeff Colyer, R-Overland Park, one of the bill”s chief authors, promise that the measure offered a first step or “potential framework” for a lengthy reform process certain to involve much discussion.
“We”re not stepping off a cliff here, we”re stepping out,” Rep. Peggy Mast, R-Emporia, a member of the subcommittee said.
Colyer was chairman of the House GOP health task force, which spent the session crafting a reform package. Mast was the vice chairman. House Republican leaders held a press conference weeks ago announcing they had a reform plan but details of it just began emerging this week.
What is now Senate Bill 11 is the apparent centerpiece of that reform package, which Colyer said would change Medicaid here along lines recently adopted in Oklahoma and Florida.
The bill”s main goal is to replace Medicaid with commercial or private insurance or other programs for those currently reliant on the government program. Its key elements include:
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Instructing the health policy authority to pursue up to nine federal Medicaid waivers in major and costly program areas including long-term care and children”s health insurance.
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A private insurance exchange or connector, but with no mandated participation.
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Initiatives aimed at promoting small business association health insurance plans.
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It also lifted the language of substitute
Senate Bill 309
, the health policy authority”s “roadmap” for long-term health care reform.
*
Premium assistance for low-income Kansans.
-Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
mshields@khi.org
or at 785-233-5443, ext. 123.