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Feb. 28, 2013
TOPEKA Six health-related bills were approved today by the state House:
• HB 2025 would create a KanCare oversight committee. KanCare is the name given Gov. Sam Brownback's Medicaid makeover initiative, which moved virtually all the state's 380,000 Medicaid enrollees into health plans run by three private insurance companies. The measure would establish a joint committee of 11 senators and representatives with the chairmanship rotating between members of the House and Senate. The first chairperson would be a House member.
Speaking in favor of the bill, Rep. Jim Ward, a Wichita Democrat, said he was not proposing an amendment to exclude, or "carve out," from KanCare services for the developmentally disabled.
"Tonight's not the night for that debate. This is a very important bill," Ward said. "But we will have that debate."
The bill was approved unanimously without debate.
• HB 2343 would create a dedicated fund for the Kansas Department of Health and Environment's laboratories, a 50-person operation that performs a variety of services, including testing for sexually transmitted diseases, blood lead analysis, water testing, DNA typing, and radiation detection.
Currently fees collected by the lab for testing environmental and health specimens are deposited to the state general fund. The bill would give KDHE discretion to set lab fees or waive them.
About $1 million in fees was collected by the bureau in fiscal 2012.
Rep. Brian Weber, a Dodge City Republican, said it was "not the intention" of KDHE to charge fees when performing tests for public agencies such as local health departments.
Ward — the lone legislator speaking against the bill — said the measure was simply a way to move $1 million out of the general fund.
"The question is, is that a good idea? ... Or is it a core state value to ensure public safety through testing of samples from folks who may not be able to afford it?" Ward said. "I think this is penny-wise and pound-foolish."
The bill passed 85-34.
• Substitute HB 2183 would give KDHE authority to order certain health care workers to be tested for infectious disease — such as HIV or tuberculosis — to prevent the spread of the disease. Workers covered by the bill include "individuals who provide medical or nursing services, clinical or forensic laboratory services, emergency medical services and firefighting, law enforcement and correctional services, or who provide any other service or are in any other employment where the individual may encounter occupational exposure to blood and other potentially infectious materials."
Existing law only authorizes KDHE to designate which diseases are infectious and to adopt regulations for the isolation and quarantine of persons exposed to the diseases to prevent their spread. An amendment approved by the House would also allow patients to request testing of themselves when exposure to infectious disease is suspected.
• HB 2146 would repeal the Cancer Drug Repository Program. Board of Pharmacy officials have said there currently is no participation in the program — which was created in 2005 to allow donations of unused cancer drugs to be dispensed to another person — because all drug donations are dispensed instead through the Utilization of Unused Medication Act of 2008. The bill was introduced at the request of the Office of the Repealer, and there was no testimony for or against it in committee.
• HB 2302 would require employees at the state’s high-security laboratory to be tested for drug use and criminal activities. Kansas Department of Health and Environment officials said the bill had been requested by the Federal Bureau of Investigation. About six people work in the high security lab.
• HB 2322 would change the name of KDHE’s Division of Health to the Division of Public Health, which officials said more accurately describes the mission and function of the division. The name change is expected to cost about $5,000 to accomplish.
There are four other health-related bills that could come up for votes on the House floor Friday, which is the last day bills can be considered by each chamber before being sent to the other.
• House Concurrent Resolution 5013 would declare that the "will of the Kansas Legislature is that the state of Kansas not expand Medicaid above its current eligiblity levels."
The Affordable Care Act, also known as Obamacare, was passed assuming that all states would expand their Medicaid programs to cover adults earning up to 138 percent of federal poverty guidelines. But the law was challenged in court by 25 states, including Kansas. The U.S. Supreme Court upheld most of the law but ruled that states could not be required to expand Medicaid.
Now, governors and legislatures across the country are deciding whether their states will open up Medicaid to new enrollees or not. Some conservative GOP governors who previously opposed Medicaid expansion now say they support it, most recently Gov. Rick Scott of Florida and Gov. Chris Christie of New Jersey.
Kansas Gov. Sam Brownback, also a conservative Republican who opposed the health reform law, hasn't said yet if he would support Medicaid expansion. The resolution is intended to deliver him a strong message that the GOP-dominated Kansas Legislature is against the idea.
• HB 2368 is part of Gov. Sam Brownback's mental health initiative proposed earlier this year. It would rename the Governor’s Mental Health Services Planning Council to the Governor’s Behavioral Health Services Planning Council, and expand its membership from 25 to 33 members.
• HB 2160 would extend until July 1, 2016 a nursing home bed assessment created in 2010. The assessment currently can be up to $1,950 per licensed bed at all nursing homes and hospital long-term care units. Revenue from the tax — an estimated $7.5 million for fiscal 2014 — would be used to draw matching federal Medicaid funding totaling $9.2 million and the full $16.7 million would then be used for nursing facilities expenditures. The Division of the Budget estimates that not extending the assessment would most likely lead to a nursing facility reimbursement reduction of 3.7 percent. The bill is supported by the nursing home industry.
• HB 2312 would raise the maximum lifetime limit for an individual covered by the Kansas High Risk Insurance Pool from $3 million to $4 million.
The pool was established in 1996 to provide coverage for individuals who have pre-existing conditions or were otherwise denied insurance in the voluntary market. Currently there are 1,416 people enrolled in the pool.
The Kansas Health Insurance Association — which manages the state high risk pool, as well as the state-based federal high risk pool established by the health reform law — proposed raising the limit because an estimated 10-13 people covered by the pool could reach the lifetime limit in 2013.
"In the event that they have a serious medical condition where they spend a lot of money, we don't want them to hit their max," KHIA Director Edwin Fonner said, noting the limit has been raised several times, most recently in 2010.
Premiums for high-risk policies are set at 126 percent of market value and all carry a $2,500 deductible, Fonner said. For example, a 17-year-old non-smoker would pay $360 per month, and a 64-year-old non-smoker would pay $1,040 per month.
For every $200 in spending, the high-risk pool collects about $125 in premiums, Fonner said. To make up the difference, Kansas insurance companies are assessed fees once or twice per year. Over the 17 years of the pool, a total of $110 million in fees have been assessed to the state's approximately 150 insurance companies, Fonner said. Increasing the lifetime limit on individuals in the high risk pool would result in increased fee assessments, he said.
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.