Medicaid

Andy Marso / Heartland Health Monitor

Kansas officials told legislators Thursday that the state's share of Medicaid expansion costs could start at $100 million per year and increase from there, and those costs could double if the federal government required full funding of waiting lists as a condition of expansion.

One day after her predecessor testified in favor of expansion under the Affordable Care Act, Kansas Department of Health and Environment Secretary Susan Mosier provided neutral testimony that warned legislators of potential fiscal pitfalls.

Dave Ranney / Heartland Health Monitor

Robert Moser, who until December was the secretary of the Kansas Department of Health and Environment, headlined a long list of Kansans asking legislators Wednesday to expand Medicaid.

Andy Marso / Heartland Health Monitor

Supporters of expanding Medicaid in Kansas are finally getting an opportunity to make their case to lawmakers.

Republican legislative leaders opposed to expansion have blocked hearings on the issue for two years. They agreed to allow hearings this year only after supporters in the Kansas House threatened to force an immediate vote on the floor.

Elle Moxley / KCUR

In Indiana, low-income people can open health savings accounts.

Utah lawmakers are building work participation and co-pays into their Medicaid overhaul.

Iowa will charge a monthly premium – and crack down on the costly practice of using emergency rooms for non-emergency care.

But as other deep-red states agree to expand Medicaid within their borders, Gov. Jay Nixon says Missouri is leaving federal health care dollars on the table.

Alex Smith / Heartland Health Monitor

In the pediatric clinic at Samuel U. Rodgers Health Center, nurse Constance Grayson gives newborn-care instructions to a jittery-looking young couple.

Samuel U. Rodgers is one of Kansas City’s largest safety net health clinics, and the doctors and nurses here take pride in offering care to all. That means learning to expect the unexpected.

But cuts in funding are something else, according to CEO Hilda Fuentes, who  recently got a letter explaining that the money she gets from the city would be cut this fiscal year by more than 10 percent, or about $167,000.

The odds that the Kansas Legislature will pass a Medicaid expansion bill this session remain long.

But they improved Thursday, however slightly, when conservative Republican leaders agreed to allow a hearing on expansion to avoid an immediate vote on the House floor.

Rep. Jim Ward, a Wichita Democrat, was attempting to amend his Medicaid expansion proposal into an unrelated bill. Uncertain how a vote might turn out, House leaders dropped their opposition to a hearing in exchange for Ward withdrawing his amendment.

Gallup is out with a new poll showing falling uninsured rates in every state but one: Kansas.

Although not statistically significant, the Sunflower State’s 1.9 point increase makes it the only state in the country to witness an uptick.

Andy Marso / Heartland Health Monitor

The chairman of a Kansas House committee holding three Medicaid expansion bills says he has no current plans to have hearings on any of the proposals.

“At this time I haven’t scheduled anything,” said Rep. Dan Hawkins, a Wichita Republican and chairman of the House Health and Human Services Committee. “Will I schedule something? I can’t say right now. But right now there is nothing scheduled.”

Now there are three.

Medicaid expansion bills, that is.

After months of behind-the-scenes negotiations with legislators and members of Gov. Sam Brownback’s administration, the Kansas Hospital Association has introduced its expansion bill.

Rep. Don Hill, a Republican from Emporia, requested its introduction in the House Appropriations Committee.

HHS.gov

Sylvia Matthews Burwell succeeded former Kansas Gov. Kathleen Sebelius as Secretary of the U.S. Department of Health and Human Services in June 2014. Before that she was Director of the Office of Management and Budget. She has also served as president of the Walmart Foundation and of the Global Development Program of the Bill and Melinda Gates Foundation.

Jim McLean / Heartland Health Monitor

Kansas hospitals are leading the push for Medicaid expansion.

But they’re not the only providers for which expansion is a critical financial issue. It’s also a priority for the safety net clinics that exist to provide free and reduced-cost care to low-income Kansans.

Alex Smith / Heartland Health Monitor

If you’re in the market for fluorescent light bulbs, you might talk to Chris Smiley. In the past few weeks, she’s been trying to sell off what’s left of Sac-Osage Hospital.

“Casework, lighting, plumping, sinks, toilets. Anything you want,” Smiley says.

That’s not in her job description. She’s actually the CEO of Sac-Osage, a hospital in Osceola, Mo., that closed in September.

“I have become an auctioneer,” Smiley says. “And I’ve learned more about asbestos and construction demolition than I ever wanted to know.”

An alternative plan to expand Medicaid loaded with clauses meant to woo Republicans has been introduced in Kansas. But it could face the same difficult political climate that killed similar bills in other states last week.

Rep. Tom Sloan said Monday that the proposal introduced by the Vision 2020 Committee he chairs represents a Kansas solution that can appeal even to those who campaigned on unwavering opposition to the federal health care reforms spearheaded by President Obama.

Kansas’ worsening budget problems are making it harder to generate a legislative discussion about expanding Medicaid.

Jim McLean / KHI News Service

A group of Kansas hospital leaders is doing what Gov. Sam Brownback has so far declined to do: negotiate with federal officials on Medicaid expansion.

A delegation of hospital executives recently traveled to Washington, D.C., to meet with officials at the Centers for Medicare and Medicaid Services and outline an expansion proposal they are developing for Brownback and Kansas lawmakers to consider this session. 

Republican Missouri State Sen. Ryan Silvey of Kansas City announced Tuesday a plan that would expand Medicaid for veterans and their families.

At a press event at the Capitol, Silvey introduced the Veteran’s Family Healthcare Act, which would provide Medicaid coverage for veterans, their spouses and dependent children with incomes between 19 percent and 138 percent of the federal poverty level.

“If we can’t solve the whole problem, let’s solve a piece of it,” Silvey said.

A federal judge on Wednesday blocked implementation of a U.S. Department of Labor regulation that would have required state Medicaid programs to pay in-home care workers minimum wage and overtime.

Experts on rural Kansas hospitals made dire predictions about their fiscal futures in a legislative hearing Wednesday that laid the groundwork for a discussion of Medicaid expansion.

Rep. Tom Sloan, chairman of the Vision 2020 Committee, said that he’s trying to start a discussion about crafting an expansion plan that addresses the needs of stakeholders and the concerns of those wary of its connections to the Affordable Care Act.

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Even as prospects appear bleak for Medicaid expansion in Missouri, a new report says the state would save $81 million right off the bat and $100 million annually later on if it expands the program.

The report by the Missouri Budget Project, a nonpartisan think tank in St. Louis, says the savings would come from money the state currently spends on Medicaid services provided to pregnant women, mental health patients and prisoners in need of medical care.

Several red-state governors have dropped their opposition to Medicaid expansion in recent months and are pursuing ways to use federal dollars to fund their own more conservative plans.

Starting this month primary care physicians in much of the country, including Kansas and Missouri, will be paid less for seeing Medicaid patients.

The expiration of a federal incentive program in the Affordable Care Act is responsible for the reduction.

Nationally, the average fee reduction is expected to be nearly 43 percent, according to a recent report from the Health Policy Center of the Urban Institute.

The newly re-elected speaker of the Kansas House reiterated on Monday that he would rather deal with the state’s budget problems by cutting spending than by revisiting the tax cuts that are shrinking state revenues.

Ray Merrick, a Stilwell Republican, was overwhelmingly elected to a second term as speaker, defeating Rep. Virgil Peck of Tyro, 80-16.

Republicans now hold a 97- to 28-seat majority in the House.

A Kansas City, Kan., home health attendant has been convicted in a federal case based on fraudulent Medicaid billing practices.

Doris Betts, 55, pleaded guilty to health care fraud in federal court. Her conviction was announced Tuesday by Kansas Attorney General Derek Schmidt, whose office is working with the U.S. Department of Health and Human Services Office of Inspector General to investigate home health care fraud in Kansas.

Post-election soul-searching by Kansas Democrats includes disagreement over whether Medicaid expansion should have been a larger part of the party’s strategy.

The Democrats lost all statewide races for the second straight time and lost another five House seats to drop their number in that chamber to 27. The defeats were part of a national wave of Republican election wins, but they have nonetheless led to talk within the Kansas Democratic Party about what could have been done differently.

The Kansas Hospital Association on Thursday continued its campaign for Medicaid expansion by reminding policymakers how much the state is losing by not claiming federal dollars to cover more low-income adults.

Andy Marso / KHI News Service

 

Kansas hospitals are moving ahead with plans to put a Medicaid expansion plan before lawmakers despite election results that returned Gov. Sam Brownback to office and solidified conservatives’ control of the Legislature.

Democrat Paul Davis favored expansion but came up short in his bid to upset Brownback, a Republican who thus far has opposed expansion. Also, several Democratic House members who likely would have favored expansion lost narrowly to GOP challengers.

Missouri News Horizon / Flickr--CC

Medicaid expansion may yet happen in Missouri, according to state Sen. Ryan Silvey.

The Kansas City Republican said on Friday that he believes he has the support he needs to pass a Medicaid expansion bill that addresses the concerns of his more conservative colleagues.

KHI News Service file photo

Medicaid expansion is more likely to be considered in the upcoming session of the Kansas Legislature if Rep. Susan Concannon is appointed to chair the House Health and Human Services Committee.

The panel is now chaired by Rep. David Crum, an Augusta Republican who has declined to hold hearings on the expansion issue for the past two sessions. But Crum is not running for a fifth term.

Bridgit Bowden / KCPT

 

Karen Barezinsky is looking for an answer to what she says is a simple question: Are the people who run Kansas’ Medicaid program planning to cut the supports she and her husband use to keep her son, Ray Santin, who’s paralyzed from his neck down, out of a nursing home?

“I can’t find out anything,” says Karen, 62, who lives in Scranton, Kan., with her husband and son. “I leave messages with Ray’s case manager, but nobody calls me back.”

Fifteen medical-related political action committees registered with the Kansas Governmental Ethics Commission had a total of almost $600,000 cash on hand at the July 24 reporting deadline, and officials from the top PACs said they're still forming the legislative agendas that may inform how they spend that money.

RELATED: Kansas Medical PACs Concentrate Spending On Incumbents

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