On April 6, 2010, the Kansas Health Institute (KHI) held an event, Meeting the Challenges of Underinsurance, to convene stakeholders around the issue of underinsurance in Kansas. This convening focused on underinsurance in the context of federal health reform and highlighted policy implications for Kansas. The event had more than 100 attendees, who represented the general public, media, the Legislature, state agencies, the legal profession, the insurance industry, hospitals, health policy research, health foundations, the health care industry and the advocacy community.
The event commenced with a greeting from KHI President and CEO Robert St. Peter and a videotaped message from Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services.
A keynote address from Kansas Insurance Commissioner Sandy Praeger followed. Her presentation highlighted areas of federal health reform that may address aspects of underinsurance. According to Praeger, coverage tiers and bans on annual limits, both components of health reform, scheduled to be implemented in 2014, are designed to ensure coverage is comprehensive and to protect consumers from bankruptcy. She also reviewed components of health reform that will be implemented soon, such as the elimination of lifetime limits on insurance coverage, coverage for preventive services, coverage for dependents up to 26 years of age, and the elimination of pre-existing condition exclusions for children.
The day continued with KHI Analyst Sharon Barfield presenting findings from KHI’s research on underinsurance in Kansas. Barfield explained that many of the underinsured Kansans interviewed for the project didn’t realize their health insurance was inadequate until they had trouble paying medical bills or were denied coverage. She discussed the financial challenges that often led these Kansans to delay care or caused them to experience significant worry, stress and lifestyles changes that worsened their health.
Gina Maree, KHI vice president for health policy and moderator of the event, then linked KHI’s research findings to federal health reform. She noted that some of the insurance reforms that address out-of-pocket expenses and health insurance benefit designs may assist some of the underinsured. However, she indicated that underinsurance will likely be an ongoing issue that will need attention at the state level.
In the afternoon, KHI Vice President for Public Affairs Jim McLean led a roundtable discussion about underinsurance in the context of health reform, featuring: Robert Bonney, senior vice president for business development for Saint Luke’s Health System; Kansas Senator Pete Brungardt; Andrew Corbin, president and CEO of Blue Cross and Blue Shield of Kansas; and Kim Moore, president of the United Methodist Health Ministry Fund. Corbin was generally positive about the health reform legislation; although, he said he was concerned the penalties in the bill would not be enough to entice people to purchase insurance. Bonney expressed concerns about the ability of the current medical workforce to serve the increase in the insured population that will result from federal health reform. Moore discussed the potential positive effect that will enable people to make personal life decisions without worrying about being able to afford adequate health insurance. Senator Brungardt said he was supportive of the goals of the new health reform law, and described some of the challenges that Kansas agencies would face in implementing the law. Overall, participants differed in their opinions about implications of federal health reform, but all agreed that some aspects of the legislation are positive. They also acknowledged that federal health reform may not be enough to address issues of underinsurance.
In the final activity of the day, attendees discussed policy implications and policy options to address underinsurance in Kansas. After participating in small group discussions, attendees shared ideas, perspective and insights with the large group. KHI Senior Analyst Suzanne Cleveland facilitated the policy discussion, in which people raised concerns about the cost of health care and potential costs of federal health reform. Dr. Andrew Allison, executive director of the Kansas Health Policy Authority, was one of the attendees and participated in the policy discussion about the anticipated fiscal impacts of federal health reform on the state. Also during the discussion, consumer advocates raised the issue of the need for changes in the restrictions associated with health savings accounts, and employees from the Kansas Department of Health and Environment spoke about the need to educate consumers about health reform and insurance options.
The convening was the second held by KHI on the topic of underinsurance and was part of KHI’s The Underinsured in Kansas project. The convening and the project were made possible by the support of six health foundations in Kansas: Health Care Foundation of Greater Kansas City, Kansas Health Foundation, REACH Healthcare Foundation, Sunflower Foundation: Health Care for Kansans, United Methodist Health Ministry Fund, and Wyandotte Health Foundation.