By Mike Shields
KHI News Service
TOPEKA, April 2
The House and Senate on Monday each approved separate bills aimed at creating a premium assistance program that officials said in its first year of operation would extend health insurance to an additional 8,500 low-income adult Kansans.
Many details of how the program would work remain to be sorted out, but the votes were significant because majorities in both chambers agreed for the first time that the eligibility requirements for adult Medicaid recipients should be loosened. In the program”s first year, it would include those earning 50 percent or less of federal poverty guidelines. At the end of a four-year phase-in, all Kansans earning 100 percent or less of the
poverty level
would be eligible.
Kansas currently provides Medicaid only to adults earning 37 percent or less of poverty, or families of two who earn about $5,000 annually. That is one of the strictest eligibility standards in the nation.
The so-called premium assistance program was tentatively approved in the Senate as Senate Bill 387.
Approval for the plan in the House came with a heavily lop-sided vote in favor of the formerly controversial House Substitute for SB 11.
House substitute for Senate Bill 11 passed 117-5 after brief discussion but no debate, after one of its chief sponsors, Rep. Jeff Colyer, R-Overland Park, introduced a single, sweeping amendment that removed the bill”s biggest political thorns.
The bill earlier had been roundly criticized by the governor, Marcia Nielsen, executive director of the
Kansas Health Policy Authority
, House Democrats and some Senate Republicans as being too far reaching and having been worked out mostly behind closed doors.
But after various private meetings alluded to on the House floor and described in interviews, revisions were written for the bill that left Nielsen and other former critics extolling the measure”s virtues.
“Today, I am thrilled that both the Senate and House recognized the importance of providing health coverage to Kansans, and working together, we are one step closer in the mile-long race to providing access to quality and affordable health care to all Kansans,” Nielsen said in a prepared statement. “We remain optimistic the Governor will sign this bill into law, and we will get to work on a long-term plan that will greatly reduce, even more so than today”s actions, the number of uninsured in Kansas.
“The Health Policy Authority and its Board look forward to working with the Governor, Legislature, and stakeholders to continue to make advances in health reform and bringing a larger plan to the Legislature in 2008.”
The House bill includes provisions for additional health care reform plans to be presented in November to the governor and legislative leaders for possible action in 2008. Those provisions also were contained in Senate Bill 309, which was approved 40-0 by the Senate on March 20 but remained stuck in the House Appropriations Committee.
House substitute for SB 11 drew only five opposing votes in the House. Colyer”s amendment was still being circulated on the House floor as the measure was voted, a fact that inspired the opposition of at least one of its opponents.
“That was something really large and we didn”t have a bill before us,” said Rep. Brenda Landwehr, chairman of the House Health and Human Services Committee. The Wichita Republican was one of the bill”s five no votes. “There”s a good chance it will have a big price tag in the out year. When I”m in doubt, I vote no.”
But Colyer said the revised bill offered something for everyone: A plan for Medicaid reform, steps to ease the numbers of uninsured and a new office of inspector general at the health policy authority to ferret out abuse, fraud and inefficiency.
In addition to the
premium assistance program
and the language from SB 309, other key elements included in the revised bill:
*
The health policy authority in conjunction with the joint committee on health policy oversight would consider as part of its health reform plans various Medicaid reform options as provided for in the federal Deficit Reduction Act and that produce cost savings for the state.
*
Interim legislative committees would examine potential changes in income tax credits for health care, increased competition in the insurance industry and policies for portability and extension of COBRA benefits from six to 18 months.
*
A safety net clinic capital loan guarantee program,
duplicating a bill already favored in the Senate
.
*
Kept the bill”s earlier language regarding expanded use of so-called 125 plans targeting small and rural businesses.
*
Use $500,000 from the state general fund to create an association assistance plan fund to aid small business associations working to provide more affordable health insurance.
*
Create an office of inspector general at the health policy authority
, duplicating a bill already favored by the Senate Ways and Means Committee.
Colyer said the amended bill was “the product of much discussion between the health policy authority, Democrats and Republicans to come up with consensus language. What is so important about this is it”sa process to reform health care over the next two and a half years. It is something we can reform in an orderly fashion.
House Democratic Leader Dennis McKinney, of Greensburg, rose to support the bill.
“This bill and this amendment puts out careful incremental steps,” he said. “I think this is a good amendment.”
Colyer said representatives of the Senate and the governor”s office also participated in the private meetings from which the compromise was developed.
Insurance industry lobbyists said they were also pleased to have been included in those discussions.
-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.