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Prepared by: Dodie Wellshear, Ad Astra Government Relations
|HB 2066: APRNs out, Medicaid Expansion In
The House on Wednesday took up debate of HB 2066, a bill that would have provided independent and unlimited scope of practice to APRNs in Kansas. What happened during that debate left many nearly speechless.
Just following the bill explanation by the bill’s carrier, Rep. Kathy Wolfe-Moore (D-KCK) went forward with an amendment to strip all of the bill’s (APRN) contents and replace it with the Governor’s KanCare expansion plan. This led to an immediate challenge by House Majority Leader Dan Hawkins (R-Wichita), a strong supporter of the APRN bill who is vehemently opposed to Medicaid expansion, to challenge whether the amendment was “germane” to the underlying bill.
The Rules Committee met on the floor and eventually ruled it to be non-germane. That ruling was immediately challenged. These challenges are rarely successful, as it takes a majority of House members to do so and Republicans most often will not vote to overrule their leaders. This turned out to be one of those rare times when Democrats and moderate Republicans joined together in a move that allowed Medicaid expansion to finally be debated in the House.
Two bills were introduced early in the session that would have expanded Medicaid, but neither the House nor the Senate leaders allowed hearings or floor debate on the bills. It has believed by many at the Statehouse that, given the opportunity for floor debate, the legislation would pass both chambers. Many will recall that it did pass the Legislature two years ago, was vetoed by then-Governor Brownback, and came just a few votes shy of an override.
During the debate, an amendment was added that would require individuals to pay a $25 per person, per month premium charge, not to exceed $100 per family. Some saw this as a way to bring in funds to help pay for the state’s portion of the cost. Many advocates see this as an unnecessary burden to qualified individuals.
In the end, HB 2066, as amended, was passed by a healthy margin of 69-54. If this were to pass the Legislature, it would provide an estimated 120,000 or more lower-income (mostly working) Kansans an opportunity for health care coverage at an affordable rate. An explanation of the new bill and the action surrounding its passage in the House may be found at this link.
Again, all content relating to APRN scope of practice was removed from the bill. Governor Laura Kelly has called on Senate GOP leaders, who are staunchly opposed to this expansion, to allow Senate debate on Sub for HB 2066.
Status of Selected Health Bills
SB 54/ HB 2102 - Expanding eligibility for Medicaid benefits to the extent permitted by the Affordable Care Act.
Status: Referred to Senate Public Health & Welfare and House Appropriations Committees, respectively. Both bills were introduced in exempt committees and do not have to meet the turnaround deadline. (KAFP supports)
HB 2066 – Expanding KanCare coverage to individuals up to 133% of the federal poverty line.
Status: Passed House 69-54; awaiting Senate action (KAFP supports)
HB 2082 - Allowing pharmacists to administer drugs pursuant to a prescription order. This requires physicians to opt-out. KAFP and KMS submitted opposing testimony centered on the fact the legislation has not been probed and vetted among professional stakeholder, and that the legislation does not provide limitations and protocols for communication between physicians and pharmacists. Pharmacist organizations center arguments in favor of HB 2082 on the need surrounding injectable psychotropic medications.
Status: Passed House, as amended, 122-1; awaiting Senate action (KAFP neutral after amendments)
HB 2402 – Provides for the corporate practice of medicine. This legislation would statutorily allow corporations to directly employ physicians and chiropractors to care for their employees. The presenting problem is that it puts the physician ultimately answerable to the employer and potentially in conflict with addressing what is best for the patient.
Status: The bill is an exempt bill and had hearings in H-Health and Human Services (KMS opposes)
HB 2389 – Requires electronic prescriptions for certain controlled substances. This is a bill advanced by WalMart and, following discussions with KMS, is expected to be amended in committee to include: application to only Schedule II – IV opioids; exemptions for those who don’t have EMR capability; and an effective date starting in 2021.
Status: Passed favorably, with requested amendments, in H-Health and Human Services; awaiting House debate
Family Doctor of the Day
KAFP sponsors the Family Doctor of the Day (FDOD) program during the Kansas legislative session. Licensed physicians, including residents, volunteer to provide mostly-minor health needs to legislators and their staff. The Legislature highly values and appreciates access to these services, especially when so many are away from their hometown primary care physicians.
Appreciation goes out to the following members, who provided FDOD care this past week: Dr. Michael Kennedy, KCK; Dr. Eric Clarkson, Pratt; Dr. Todd Miller, Wichita; and Dr. Lynn Fisher, Plainville. Thank you all for your generous gift of medical care at the Capitol!
Note: Dr. Clarkson was on hand to witness the HB 2066 debate on Wednesday and Dr. Miller was there to witness the final action vote on Thursday.
Committee Meetings: Week of March 18-22
The House and Senate will be devoting Monday, Tuesday, and Wednesday to floor debate. Only one committee of note has a meeting planned this week.
Monday, Mar 25
Noon, S-Public Health and Welfare, Room 118-N
Final action on bills previously heard
- SB 234 – Requiring electronic prescriptions for controlled substances.
Following is the legislative plan for the remaining 2019 regular session.
- Monday/Tuesday/Wednesday: On floor all day, with Wednesday as “Drop Dead Day,” the last day for consideration of non-exempt bills in either chamber
- Thursday/Friday: No sessions
- April 1-2: Conference committees meet
- April 3: Last day for conference committee agreements
- April 4-5: Consideration of conference committee reports, First Adjournment
- May 1: Veto Session begins
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