By John Hanna, Associated Press

TOPEKA -- Republican Gov. Sam Brownback won't delay an overhaul of Medicaid in Kansas, officials said Thursday, despite bipartisan concern among legislators that his administration is moving too quickly to turn the entire program over to private health insurance companies.

Brownback expects the state to issue contracts this year to three companies to manage the $2.9 billion program, which provides health coverage to poor families and disabled and elderly Kansans.

The contracts would take effect Jan. 1, 2013. Each company must provide coverage statewide, so that participants can choose among plans. The administration also is promising that the contracts will contain financial incentives for the contractors to improve services while controlling costs.

State medical programs provide services for an average of 380,000 people a month, and the bulk already receive state health coverage through private contractors. But Brownback's overhaul represents the state's first attempt to bring services for the disabled and the elderly, including nursing home residents, into a managed-care system.

Some legislators think Brownback's administration is rushing the changes, but Lt. Gov. Jeff Colyer said when the new contracts take effect next year, nearly two years will have passed since the administration began discussions about overhauling Medicaid. Colyer said the changes will not only to control costs but better coordinate care and improve individuals' health.

Asked about delaying the overhaul, Colyer told The Associated Press, "Why would we?"

"We don't want to hurt Kansas patients," said Colyer, a surgeon and former state senator who led the team that developed the overhaul plan. "We want to make sure that they start getting the benefits now, and we're talking about tens of millions of dollars."

Companies seeking one of the Medicaid contracts have until Tuesday to submit the technical details of their proposals to the state, then until Feb. 22 to submit the rest. Up to 15 companies can bid, including Aetna Inc., United Healthcare, WellPoint Inc. and Blue Cross and Blue Shield of Kansas, the state's largest health insurer.

"The bottom line is no — no, the administration is not considering delaying it," said Brownback spokeswoman Sherriene Jones-Sontag.

Legislators have acknowledged that their role in the overhaul will be limited because most changes will be handled through the contracts, though they must agree to a reorganization of the state's health and social services agencies, and they can weigh in on budget issues.

The House Health and Human Services Committee planned to hear a presentation Thursday afternoon from Health and Environment Secretary Robert Moser, a physician who also was on the Medicaid overhaul team. The Senate Public Health and Welfare Committee heard testimony earlier this week.

Sen. Dick Kelsey, a Goddard Republican, said Brownback should delay the start of the Medicaid contracts for six months, until July 1, 2013, and remove services for the developmentally disabled from the contracts. Some Democrats also have said the administration should slow down.

"I don't believe that changes this massive can be made in this time frame successfully," Kelsey said. "It will be a tremendously chaotic thing."

Rep. Jerry Henry, of Cummings, the top Democrat on the House Social Services Budget Committee, said he's most concerned about how the overhaul will affect services in rural areas, where providers are fewer. He said the administration could do better by imposing changes in urban areas first then expanding into rural areas.

Advocates for the developmentally disabled also have voiced concerns about how the changes will affect services and clients' existing relationships with community service groups.

Tom Laing, executive director of InterHab, a group representing service providers, said managed-care providers focus on administering services to lessen future medical problems and costs. But, Laing said, while developmentally disabled Kansas could benefit from such an approach for medical or mental health services, they also depend upon in-home services designed to promote their independence.

Brownback's administration has promised that new contracts will require companies to work through existing service providers. Also, Colyer said, Kansans with long-term needs will benefit the most from having better-coordinated services.

If the state delays the overhaul, Colyer said, "It will cost us millions of dollars, and it's a worse health outcome."

Senate health committee Chairwoman Vicki Schmidt, a Topeka Republican, doubts legislators can force Brownback's administration to alter its schedule for overhauling Medicaid. Instead, she said, she wants to create an oversight committee to monitor the effort.

Other legislators acknowledged that they're relying on public pressure to persuade the administration to slow the overhaul.

"If you move too quickly on this, it's bound to fail," said Sen. Laura Kelly, of Topeka, the ranking Democrat on the budget-writing Senate Ways and Means Committee.