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Medicaid Expansion Roundtable

from Prepared by: Dodie Wellshear, Ad Astra Government Relations

The House Health and Human Services held a three-day roundtable discussion on the benefits and challenges of expanding Medicaid in Kansas. Included in the roundtable panel were representatives of physician, hospital, charity care, and other healthcare advocacy groups, as well as outside think tanks and researchers. The forum was set up so that legislative committee members could freely ask questions of the various panelists.

Nearly every in-state panelist represented stakeholders firmly committed to KanCare expansion. Out-of-state panelists included some who studied other states’ experiences and think tanks.

KAFP was represented on the third day of the roundtable by Dr. Jen McKenney, Fredonia, with Dr. Bob Moser, another KAFP member, representing the rural and “how-to” perspective. Dr. McKenney discussed her own practice and the cost of unreimbursed care, along with the health challenges faced by those who don’t have health care coverage. She talked about the impact of three hospital closures in SE Kansas, causing physicians to leave those communities and patients needing to drive anywhere from 25 minutes to more than an hour to receive medical care. As challenged by the committee chair, she presented specific health outcomes that could be measured – as is currently done in the ACO she belongs to – to ensure health care coverage is indeed making a meaningful contribution to healthier patient outcomes.

One outside think tank representative created angry ripples when he suggested hospitals and providers would do better if they simply operated more efficiently, rather than expanding Medicaid. He also launched into a litany of problems he sees with Kansas’s health care delivery system – mostly related to what he calls free-market principles.

He said requiring telemedicine services to be delivered by those who are licensed by the Board of Healing Arts, having limitations on mid-level providers’ scope of practice, and not allowing the corporate practice of medicine were all responsible for driving up health care costs – and pointed to provider “greed” as being an issue. He furthered by maintaining health care coverage has no impact on health outcomes in patients.

One of the strongest statements of the days’ discussions was made by a representative of a charitable care network reminding the group that health care services are still being delivered by providers across Kansas – those services are just not being reimbursed.

Where the Legislature goes from the roundtable discussion is still up in the air. Bills expanding KanCare have been introduced in both the House and the Senate – both introduced in committees exempted from deadlines – but no hearings have been held on them. It is widely believed expansion legislation would easily pass, if ever brought to chamber votes. Such was the case two years ago, when then-governor Sam Brownback vetoed the legislation and it came just a few votes shy of the two-thirds majority needed to override that veto.

The two bills awaiting legislative action are HB 2102 and SB 54.

The Coming Week
Committee meetings on health issues will be sparser this week. The House Health and Human Services Committee is scheduled to again take action on HB 2066, regarding unlimited and independent scope of practice for APRNs, on Wednesday. This bill was scheduled for House debate before turnaround, but was pulled from the calendar and “blessed” by House leaders for later action.

Two different takes on legalizing the medical use of marijuana will also receive hearings in the coming week. more

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