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March 1, 2013
TOPEKA The House passed two more health bills today before adjourning until Wednesday, when it reconvenes for the second half of the 2013 legislative session.
A resolution opposing the expansion of Medicaid eligibility was on the House calendar but didn't come up for debate.
Here's what was passed Friday:
House Bill 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 as the Governor’s Behavioral Health Services Planning Council and expand its membership from 25 to 33 members. It was passed without opposition.
HB 2312 was also approved unanimously. The measure 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.
House Concurrent Resolution 5013 — a non-binding measure stating that the "will of the Kansas Legislature is that the state of Kansas not expand Medicaid above its current eligiblity levels" — wasn't put to a vote.
However a resolution is not subject to the same deadlines as bills and likely will be taken up later in the session.
“The decision to expand Medicaid is one that deserves an up or down vote," said House Speaker Ray Merrick, a Stilwell Republican. "If the governor chooses to expand Medicaid, the Legislature would be responsible for appropriating the funds, so it’s natural that the body has a vested interest in participating in the expansion discussion."
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.
Another health-related bill not yet put before the full House, HB 2160, was passed out of a budget committee and is expected to be taken up later this session.
The measure 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.
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