State leaders tout Medicaid reorganization

By John Hanna, Associated Press

TOPEKA - Gov. Sam Brownback and several top administration officials sought to dispel doubts about his plan to overhaul the state's Medicaid program, declaring Thursday that the planned summertime reorganization of three government departments will improve services for the poor, disabled and elderly.

The conservative Republican governor plans to turn over management of the entire $2.9 billion-a-year Medicaid program next year to three private companies. Before then, in July, the state will reorganize its departments of Aging, Health and Environment and Social and Rehabilitation Services.

Brownback, Lt. Gov. Jeff Colyer and the three agencies' secretaries had a Statehouse news conference to publicize the coming reorganization, which will consolidate programs providing long-term care for both the elderly and disabled into one agency. The reorganization also will eliminate 10 administrative jobs and permit SRS to focus on services for families and children.

Administration officials said the agencies' reorganization is a crucial to overhauling Medicaid to improve the coordination of care and overall health of participants and reduce the state's costs. The overhaul has drawn bipartisan criticism, though the agencies' reorganization attracted no significant legislative opposition.

Brownback issued an executive order in February to reorganize the agencies, and the state constitution gave legislators until last week to block it. They didn't act before starting their annual spring break at the end of March.

"We want Kansas to work better," Brownback said. "We want it to work more efficiency, so that we can afford the services that our vulnerable community needs."

Brownback's administration is reviewing bids from five companies that are all based outside Kansas or are affiliates or subsidiaries of out-of-state companies. The administration plans to issue three contracts this summer, with each company operating statewide so Medicaid participants have a choice of managed-care coverage.

Most of the 385,000 Kansans receiving state medical assistance have managed-care coverage through private contractors, but the overhauled Medicaid program, to be called KanCare, would be the first time Kansas has brought the disabled and elderly, including those in nursing homes, into such a system. An increased number of Kansans needing relatively expensive long-term services would be covered by managed care.

Legislators reconvene April 25, and advocates are expected to push lawmakers to "carve out" services for the developmentally disabled from the KanCare contracts. Advocates persuaded the Shawnee County Commission to adopt a resolution Thursday asking Brownback to reconsider the overhaul, The Topeka Capital-Journal reported.

Senate Minority Leader Anthony Hensley, a Topeka Democrat, said the news conference with the governor, three Cabinet secretaries and Colyer, the architect of the Medicaid plan, shows Brownback's administration understands it still faces a "hard sales job."

"There's a lot of skepticism about this whole issue," Hensley said.

The reorganization will move oversight of the state's five hospitals for the mentally ill and developmentally disabled from SRS to the Department on Aging, along with other services for the disabled and mentally ill. The Department on Aging also will take over some regulatory functions from the health department.

It will become the Department on Aging and Disability Services. The health department will oversee Medicaid's financial management, and SRS will become the Department of Children and Families.

SRS Secretary Phyllis Gilmore said that as part of its new, narrower focus, reorganized her department will seek to hire at least 20 additional social workers to help children in troubled families.

Colyer said: "The point of this is focus, and so what we're trying to do is focus on core missions."

Tagged: Medicaid, Gov. Sam Brownback


Richard Heckler 6 years, 2 months ago

Conservatives and liberals may disagree about the constitutionality of the individual mandate requiring all uninsured Americans to buy health insurance from private companies or pay a penalty to the IRS.

But there is no debate about whether single-payer Medicare For All would be constitutional. No one — not even the most hard core, right-wing libertarians — disputes that the federal government has the constitutional authority to tax all Americans to pay for Medicare-style health insurance for all, as it pays for Medicare for everyone over 65.

Indeed the Republican Attorney General of Louisiana, Buddy Caldwell — who is one of the attorneys general opposing the Affordable Care Act (“ACA”) in the Supreme Court — is against the Individual Mandate because it props up the private health insurance agency and he prefers single payer. “Insurance companies are the absolute worst people to handle this kind of business,” Caldwell said last week outside the Supreme Court. “If you have a hurricane come up the east coast, the first one that’s going to leave when they gotta pay too many claims is an insurance company.” Caldwell went on to endorse the idea of a government backed single-payer system as “a whole lot better” than mandating private insurance.

As a legal matter, the constitutionality of the individual mandate should not be a particularly difficult law to uphold unless a radical right-wing majority of the Supreme Court is prepared to upend 75 years of jurisprudence on the Commerce Clause.

But as a political matter, the enthusiastic support for the individual mandate by liberals and Democrats should trouble real liberals. Private health insurance is a defective product that often isn’t there when people need it most. Even with government subsidies, the combination of premiums, deductibles and co-pays under the minimum policies required by the ACA could force many middle class Americans into medical bankruptcy or lead them to avoid preventive care and wait to see a doctor until they’ve become really sick.

Liberals should be troubled by the federal government forcing every uninsured American to buy a defective product from a for-profit health insurance company or be penalized by the IRS. Why do liberals want Uncle Sam to be the repo man for the likes of Aetna and United Health Care?

Richard Heckler 6 years, 2 months ago

People/voters/taxpayers/consumers/middleclass/ all have this problem.

It is looking up to the wealthy to represent values many of them know nothing about either because they have never lived it or forgot.

The wealthy want to be in government to protect their investments and their beyond reality lifestyles. Why in the world would people/voters/taxpayers/consumers/middleclass/ want to vote them in office? Why not vote into office People/voters/taxpayers/consumers/middleclass/ lifestyles and protections for our jobs?

lucky_guy 6 years, 2 months ago

This is a money grab for Brownie's campaign fund. There was and never will be any savings. How can any private company that has to make 20 or 30 percent profit do that without cutting services and turning out patients? No way, no how.
This is a money laundering scheme pure and simple, since citizens united the companies who want the medicaid bids will be the ones that contribute the most to the gov's campaign chest and away we go. Why do you think they want to lump everyone into the same basket? Could it be less oversight? hmmmmm/

Paul R Getto 6 years, 2 months ago

Ignore what Muscular Sam says and watch what he promotes as state policy. There are only two objectives: Spend less money on those in need and give tax breaks to those who are not.

Paul R Getto 6 years, 2 months ago

Ignore what Muscular Sam says and watch what he promotes as state policy. There are only two objectives: Spend less money on those in need and give tax breaks to those who are not.

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