Kansas Health Institute | Information For Policy Makers. Health for Kansans.

TOPEKA — The Kansas Health Policy Authority has 233 employees.

Forty-three work for and are paid by the state employees’ health insurance plan.

The other 190 oversee the state’s Medicaid program. Sixty percent of their salaries are underwritten by the federal government. Most of the remaining 40 percent is financed by the State General Fund.

The House Social Services Budget Committee last week proposed cutting health policy authority salaries by $800,000; the Senate Ways and Means Committee recommended cutting them by $200,000.

To accommodate an $800,000 cut, the agency would have to lay off 45 of its 190 Medicaid workers – that’s almost one-fourth of the workforce.

Members of the agency's board reviewed these facts Tuesday during their regular monthly meeting.

“It’s frightening, it’s hard to come up with another word to describe it,” health policy authority Executive Director Andy Allison told board members.

The state’s Medicaid operations, he said, would be at risk of falling out of compliance with various federal rules governing the program, which could result in the state owing the federal government millions of dollars.

Allison said the $200,000 cut, also would be difficult to implement.

“We’re already stretched pretty thin,” he said.

Board members said they didn't understand why legislators – assuming they were well-informed – would propose such deep cuts.

“There’s a real disconnect,” said Ray Davis. “Here we’re dealing with increasing numbers of uninsured and the likely difficulties in meeting federal mandates tied to health reform and then we turn around and there’s a disaster at the doorstep. I’m not sure the Legislature catches it.”

“This is pretty discouraging,” said Ken Daniel, a small business owner who represents the Topeka Independent Business Association.

Dr. William Reed, appointed to the board earlier this year, said he wondered if there was some political fence-mending to be done.

“I get the feeling that not everything before us is related to the budget, that there may be a lack of communication,” said Reed, chairman of the University of Kansas Hospital’ Department of Cardiovascular Diseases.

Scott Brunner, chief financial officer and director of operations at the health policy authority, told the board the cuts were driven more by revenue shortfalls than ill-feelings toward the agency.

But board member Dr. Vernon Mills, a Leavenworth pediatrician, disagreed. Legislators, he said, know what they’re doing.

“This is all ideological,” said Mills, an outspoken proponent for health reform. “I’m not going to change my mind, the truth is the truth: They haven’t performed well as a Legislature. We’ve given them options and they’ve ignored them.”

Mills said legislators – not the health policy authority – are “out of step” with the people of Kansas.

“Every day, I have patients tell me how dysfunctional the health care system is – whether they have insurance or whether they’re conservative politically, it doesn’t matter,” Mills said. “The Kansas Legislature does not represent their interests.”

Daniel said he thought there “is still some saber-rattling” left over from the 2008 controversy when the board included a cigarette tax in its 21 priorities for state health reform.

Despite the proposed salary cuts, legislators have directed the health policy authority to generate almost a dozen policy reports by the end of this year’s legislative session.

Allison said the reports will be turned in on time despite the strain on staff.

Daniel said that may not be a good idea.

“We keep meeting the challenges they put us up to – you do too good a job,” he said. “It’s like you’re crying wolf.”

Allison was in Washington, D.C. for a National Governors Association forum on health care reform. He addressed the board via speakerphone.