By Jim McLean
KHI News Service
TOPEKA, Feb. 8
A Kansas Senate task force is urging passage of a package of health reform measures including two that would make significant changes in the state”s HealthWave program and the private insurance market.
The package of proposals was unveiled Thursday at a Statehouse press conference that was attended by several of the Republican members of the Senate Health Care Task Force, but neither of the panels” two Democrats.
The most far-reaching of the measures would create a Kansas healthcare connector, a new insurance marketplace where individuals would purchase group coverage with assistance from their employers, rather than relying on employers to select a plan and purchase it for them. Individuals who buy insurance through the connector would be allowed to use pre-tax dollars, which, supporters say, would make premiums more affordable.
The approximately 38,000 state employees now covered by a state plan would be used to initially constitute the group to ensure a large risk pool.
The proposed “connector” is similar to a mechanism used in the universal coverage law now being implemented in Massachusetts. It remains to be seen whether the Kansas version would
as the Massachusetts law does
require individuals to purchase insurance and employers to participate in the system. A version of the connector model developed by the
Heritage Foundation
, a conservative, Washington, D.C. think-tank, is contained in Kansas Senate Bill 309, which was introduced earlier this week.
Sen. Jim Barnett, R-Emporia, chairman of the task force, said the proposal is aimed at ensuring the approximately 300,000 Kansans who currently lack coverage. And he said it is designed to reform the current employer-based system, which he charged doesn”t work.
“This is our opportunity to get our arms around those 300,000 uninsured Kansans,” said Barnett, flanked by Senate President Steve Morris, R-Hugoton and Sen. Roger Reitz, R-Manhattan, who, like Barnett, is a physician.
Barnett cited data supplied by the Heritage Foundation that shows that more than 60 percent of people who are uninsured at any given time previously had coverage.
“But when they change jobs they lose their insurance,” he said. “And it”s because our mechanism now in America for providing insurance is employer-based. We need to change that so that individuals own the policies.”
Marcia Nielsen, executive director of the
Kansas Health Policy Authority
, recently told members of a House task force that research showed that the primary reason people don”t have insurance coverage is because they can”t afford it.
“It”s just that simple,” she said.
Under Barnett”s proposal, individuals would have a choice: purchase insurance through the connector, or pay into an account that could be used to cover any future health expenses.
Sen. Laura Kelly, D-Topeka, a member of the task force, said there wasn”t consensus on the panel about the connector proposal. Rather, she said there was general agreement that a connector model would be among the approaches considered by the health policy authority”s Health for All Kansans Steering Committee over the course of the next year in developing a comprehensive health reform plan.
“That”s what I remember hearing,” Kelly said. “So, I was a little surprised to see that as a recommendation of the task force.”
Covering children
Barnett and the Senate task force favor stepped-up efforts proposed by the health policy authority to enroll children in the state”s
HealthWave
program, which is a combination of its
Medicaid
and State Children”s Health Insurance programs. Currently, between 66 percent and 71 percent of uninsured children are eligible for Medicaid and SCHIP coverage but not enrolled.
“While we”re figuring out where we are going with all this, we”ve got to make sure our kids are covered,” Kelly said, confirming there was bi-partisan support for that plank in the task force plan.
However, there isn”t agreement on Gov. Kathleen Sebelius” $10 million proposal to expand eligibility for HealthWave programs in an attempt to cover all children from birth to age 5.
“We have concerns that the current system is not working and we think it”s time to look for a different system,” Barnett said, explaining that he would prefer to seek waivers from the federal government that would allow the state to buy private health coverage for Medicaid and SCHIP eligible children and families.
Gov. Sebelius, in a statement issued late Thursday, said she was glad the Senate task force supported the expansion of HealthWave enrollment efforts but added, “I hope the full Senate will once again endorse my proposal to provide health insurance for every Kansas child from birth to age 5.”
The Senate approved funding for a similar proposal last year, but GOP leaders in the House declined to go along, citing concerns about the long-term costs of expanding eligibility criteria.
In an indication that this year”s proposal from the governor remained alive in the Senate, Morris said he remained open to it.
“I don”t want to give up on anything that”s viable,” he said.
Though the governor continued to press for her birth-to-five initiative, she said she welcomed the increased legislative attention to what she called “the crisis in our health care system.”
“This year is the year for action and I know that all Kansans are eager for us to work together to make quality health care more affordable and more available,” she said.
Sebelius is scheduled to address the first meeting of the health policy authority”s Health for All Kansans Steering Committee, which will begin at 1:30 p.m. Friday in the Eisenhower State Office Building.
Prevention and detection
The Senate task force endorsed a proposal to significantly expand the number of potentially life-threatening, but treatable, conditions for which newborn babies are tested. Currently Kansas is one of only a handful of states that tests for fewer than 10 of these conditions. The proposal under consideration would expand that to 29, the number recommended by the Kansas Department of Health and Environment and the American College of Medical Genetics.
The task force also called for passage of Senate Bill 318, which would increase funding for tobacco prevention programs in Kansas by an additional $15 to $16 million.
The state”s award from the Master Settlement Agreement, the 1998 settlement between tobacco companies and states to reimburse them for medical costs attributed to smoking, will increase beginning in April 2008. Senate Bill 318 requires that the additional funds be used exclusively for smoking prevention and cessation programs.
The state receives about $50 million each year from the MSA. Most of the funds are used to pay for social and health services for children; $1 million is allocated for smoking cessation and prevention programs.
The Centers for Disease Control recommends that Kansas spend about $18 million each year on those programs.
One idea that didn’t make the Senate task force’s list of recommendations was a proposal to allow parents to carry their children on health insurance policies
up to age 25. The cut-off now is age 23.
Barnett said the proposal would point the state in “the wrong direction.”
“We need to have a culture that says ‘you need to go out and buy insurance,'” Barnett said.
Approximately 33 percent of uninsured, working-age Kansans are between the ages of 18 and 25.
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.