Full Transcript

Theresa Freed 0:00

Each legislative session, KHI is hard at work keeping you informed on the latest health policy discussions from across the street in downtown Topeka. Health at the Capitol is a KHI production, a monthly recap with our legislative monitoring team, offering you a closer look at policy work happening now in Kansas and coming up. Thanks for joining us for Health at the Capitol. I’m Theresa Freed, your host, and I’m joined by Linda Sheppard and Valentina Blanchard, who are our legislative monitoring team. Alright, so we are talking about first adjournment, which happened last Friday [March 27, 2026]. So that’s where we’re at in the legislative session. So Linda, just starting us off with kind of what’s been happening.

Linda Sheppard 0:45

Yes, so last week was a busy week, obviously, last week of the session, before first adjournment, the the legislators, they were here very late on Thursday night and and on Friday, trying to get all the things done that they needed to get done.

Linda Sheppard 0:56

You know, just at a high level, you know, they had two really important priorities that for the session a lot of sessions, but one different was the getting the budget. That’s something that they have to do every year, and they were working on that clear pretty much to the end. Conference committee met numerous times last week, and actually starting the week before even trying to get get to their budget. So there’s a budget that is going to Governor Kelly for consideration. You know, I have certainly heard and expect that there will be some line item vetoes, and so there will be some things that they’ll want to work on when they come back from the veto session. The other big thing really doesn’t have anything to do with in terms of health, but they, they were really focused on getting a property tax bill done, and they got something done, but it’s, you know, it’s sort of a two-piece process for them, and so I think there’ll be some additional work maybe on that area when they come back, but that seemed to be a real challenge for them to get to agreement on that. So, so that’s done.

Theresa Freed 1:19

Sort of the indirect tie to that is, you know, obviously that has an impact on families when they can’t necessarily afford property taxes or older adults, and so it sort of speaks to the affordability aspect. So very indirect, but however, still linked to health, as many things are, right?

Linda Sheppard 2:17

The other thing that I wanted to mention was the fact, we talk about our small but mighty legislative monitoring project team that we have here at KHI, and one of the things that happened last year, and so, you know, I’ve been doing this for like, you know, about a dozen years now. And so anytime something happens that I haven’t seen before, that always stands out in my mind,

Linda Sheppard 2:40

that the number of bills that they shuffled around. So, you know, we, I think Val was going to mention this, you know, we have some bill numbers, you know, that we’ve been using all session long. And as of last week, they become meaningless because the text of that bill’s moved into this bill and there and then. So they were doing a lot of that at the conference committee level, doing a lot of that, shuffling around and moving bills into shells that that they had removed other language out of. And so it was, it’s been a little bit of a challenge to try to keep up with those. And I think also, you know this is Wednesday now, the week after or the Wednesday after first adjournment, and the reviser’s office is still busy trying to get, you know, new versions of bills updated and ready to be sent on to the governor. So they’re still working through that process. And, yeah, if you want to see a final bill, there are some that are not available.

Theresa Freed 3:42

So can you talk a little bit, maybe, about what’s, what’s the strategy in that? Why all the movement?

Linda Sheppard 3:49

Well, a lot of times, if they have things that they want to get done, and they really are just starting to run out of time. Taking those bills, they will, they will use, and I used the word “shell” earlier, they’ll have a bill that’s maybe already gotten way through the process, and they take the text out of that bill, and then they put text from other bills that maybe haven’t gotten as far into that, and procedurally through the rules they’re allowed to do that. And so it makes so that they can look at all of those at one time, when it goes to the floor and so they get a lot done by some movement around, of some texts within the bills that are already progressing.

Theresa Freed 4:32

And so we’re already seeing, or still seeing, rather the, not an expedited session, we used that term a little bit last time, but it is really a quick moving one.

Linda Sheppard 4:41

Now it is, and they even sped up this year even more, so I think we mentioned during our preview conversation that this is the second year that they’ve been on this accelerated schedule where they are really focused on the 90 days that are in the Constitution. And, really just getting that done, so not taking much in the way of breaks anytime during that 90-day session, which is something they had done in the past. So you know, here we are. First adjournment was last Friday. They’ll be back on April 9 for the veto session, maybe a two-day veto session, and then they’ll be done. And again, as we discussed, all of the house representatives positions are up for re-election this year, so they’re anxious to be able to get out and do there campaigning now.

Theresa Freed 5:31

Yeah, that makes sense. Alright. Well, let’s take a closer look at some of the bills that made it through. Some of them got a little bit stalled, and so we’ll talk through through some of those items that we mentioned last time, so we can start maybe with the BPMs and a reminder of what that stands for.

Valentina Blanchard 5:48

Yeah, so the pharmacy benefit manager bill did end up getting passed, so there’s some some new regulations that will be associated with how they register in the state and things like that. So that bill is still pending enrollment. So once a bill is enrolled, the governor has 10 days to sign it into law. If she doesn’t sign it within those 10 days, and it just automatically becomes law. So that’s one of the ones that’s still waiting to get sent to the governor.

Linda Sheppard 6:11

You know, a couple of things that, and one thing that stands out, really, in my mind, that is a big provision in there. So PBMs, pharmacy benefit managers, these are organizations that are used by health insurers to help manage the whole drug part of the prescription drug part of their plans. And for a long time now, there has been some ongoing concerns in terms of how they do, what they do, basically, and the lack of ability of being able to have a real clear understanding of how that process works, or how they determine which drugs are available at what cost, how much is going to get you know, how much other pharmacists who are dispensing those pills, how are they going to get paid, and how much, and how that compares to other things that they’re doing? So, there’s been this overall transparency concern, and a lot of states have started a few years ago, to start putting some some state-level legislation in place to get some more regulatory authority over these PBMs. And there’s also action happening at the federal level as well. And I think because that really hasn’t been fully fleshed out yet, some states like ours are continuing to look at doing something for themselves. I will say that one piece in this bill that is, I think, is very important, because I think it remains to be seen if it’s controversial, or, I think right now people are concerned that it is. One of the things that we heard from talking to the pharmacist was the the amount of money that they get reimbursed for a drug that they purchase and then dispense for that particular company’s enrollees and those are arrangements that are made between the PBM often in the pharmacy about how they’re going to get reimbursed. And one of the things that we heard about was this idea of the dispensing fee is that? What it is. Yeah, it’s the dispensing fee that they get paid. So it’s like, you’re going to get reimbursed for the drug, but you’re also going to get this extra fee because of the process that you went through to get it ready for our patient. And so in this bill, there is a specific provision requirement, $10.50 dispensing fee in there that the PBMs will be asked to to pay for that. And of course, then the question remains, well, does that just get passed down to the consumer at some point? Because the PBM now has to pay this additional fee, so it is something I think particularly the independent pharmacy, so the small community pharmacies were saying, you know, we really need some some help, because we’re not getting reimbursed enough to really keep our operations going. And so I think that was the purpose for that fee. But we’ll see what happens with that.

Theresa Freed 9:10

Well, I appreciate the clarity. I think that is some helpful background information. So another one that we’ve been watching is the cell phone bill, and so we know that that one got signed into law. And so what does that mean now?

Valentina Blanchard 9:23

So that means now that schools will be required to either adopt a policy, if they don’t already have one, or change their policy so that it matches what was passed in the bill. You know, one of the discussions around that was the fiscal note associated and what the cost would be to districts. I think there’s still some details that that will need to be worked out. But, you know, it was a bipartisan bill. Both sides are very excited about it, and the governor had a whole signing with photos and all of that. So it’s definitely a bill that seems really important to Kansans, and we’ll see kind of how it rolls out now that it’s been signed.

Theresa Freed 10:01

And I noticed, this is not necessarily something, that Kansas is the only state doing this, but we’re one of the first states to do it, right?

Valentina Blanchard 10:10

Yeah, we’re one of a few. Florida was the first state to do anything. I think back in, I think before 2020 they passed a bill. So we’re definitely not the first, but we’re definitely not the last in this case. We’re kind of right in the middle. And then we’re also seeing some other countries do do some things related to cell phones and youth usage as well.

Theresa Freed 10:33

Yeah, and I think this is probably one of those topics that you know, obviously will continue to come up, maybe not a cell phone ban in schools, but the regulation of content for students and young people, you know, for example, seeing the social media lawsuits and the decisions coming from that, there is this growing interest in protecting children from a very rapidly evolving technology that kids have some exposure to. So any other topics related to that that have come up during this session, or that you would anticipate maybe what we might see down the road?

Linda Sheppard 11:10

There was the, they kept calling it the app bill, because just for short, but this was a bill that, again, as we talked about at the beginning of the session, there has been so much focus on child welfare, things to protect children, things that are to improve situations for children. And so this bill came up and would be placing some new requirements on the app stores so to try to make sure that the people that are going on to those app stores that are buying those apps are actually of age, and putting some some requirements on them about how they would have to determine the age of whoever it was that was trying to to get the app and, you know, and again, like everything else, I mean, this is another controversial thing, because the app stores are saying, “No, it shouldn’t be us. It should be a different, you know, a different entity within the line of the internet.” And so again, you know, lots of states are trying to figure this out, trying to figure out, how do we best protect the children from things that we’re concerned about on the internet.

Theresa Freed 12:21

It’ll be a very interesting discussion moving forward, of course, and we’ll be paying attention. So another hot topic was related to the nursing board, and there’s been a lot of activity within the last couple of weeks, I think about that. You want to touch on that.

Linda Sheppard 12:34

So the nursing board situation that actually started before the session happened. They had an interim committee that was meeting that was looking at workforce issues and other things, and this issue came up that there had been instances of the way that the nursing board interpreted the statutes and regulations that they had in place at that time. Yeah, that it how they respond and how they characterize situations in which a nurse, her license lapses, or, you know, something, something in the re-registration, re-licensing process gets dropped somewhere, and then, how is that characterized? And then how does that go on to the nurse’s record for future? And so there were a number of nurses that came in and told stories of their own experiences about going through that and the fact that if that would show up on their record as non-professional conduct, then tried to go get other jobs in different places, or several of the nurses are interested in belonging to one of the compacts, which we might mention later, that that shows up in their record and potentially interferes with their ability to be able to be that participant or to get licensed in another state. So this really was a major overhaul. The legislature went as far as voiding those types of things that had happened to nurses clear back to 2005. Yeah, so like a really big step backwards and said all of those types of rulings from 2005 to current were basically voided and would be removed from their records at some point. And then going forward, the way that those types of, what they refer to as non professional, I mean, they really don’t relate to their working as a nurse. These were the paperwork, things that happened in the background that those sorts of non professional violations or situations that technically do violate the the law, but providing some more flexibility for how the nurses are notified when they’re license is coming up for renewal, or all of this hasn’t been done, and you have a certain amount of time you have to get this done, but were really taking away, I think that whole, you know idea of this is something that that affects your ability to be a nurse. And I think that’s the really the issue for that.

Theresa Freed 15:20

It seems like workforce was a very big topic, whether nursing or another health-related profession. So Val, do you want to talk about some of those pieces of legislation that we reviewed earlier?

Valentina Blanchard 15:32

Yeah, so we talked about compacts, I think, a couple times, and they did move all the compacts into one bill in a conference committee. So occupational therapy, respiratory therapy, athletic training, those are all going to be compacts that Kansas will be a part of. And then once the seventh state signs if, if not already, those compacts will be enacted. And then there was also some bills kind of related to, like some of the student loan programs, and addressing some of those workforce shortages at the education level, versus once someone is already in the workforce.

Theresa Freed 16:08

Okay, and so when we talk about compacts, describe a little bit about what that means in terms of flexibility to where professionals work.

Valentina Blanchard 16:16

So just makes it easier for someone who may be licensed in Missouri to get their license in Kansas, or whoever is part of the compact, so someone could move to the state and start practicing sooner than if they had to go through the application licensure process from the very beginning.

Theresa Freed 16:34

Okay, alright, and so just moving on now, I guess to the veto portion of our discussion here. There is a difference in opinion, I think, on some of our pieces of legislation by the time they hit the governor’s desk. And so, are these vetoes out of the ordinary? Do you think, or it seems like there have been a lot lately? Or is this pretty, pretty typical, when we get to this stage.

Linda Sheppard 17:01

I would definitely say it’s not out of the ordinary. I mean, I think throughout, certainly through any type of situation where we have here in Kansas with a Republican majority legislature and a Democratic governor, and so for the last eight years, you know, Governor Kelly being in that role, and she’s been very public about the issues that she cares about, or the things that she thinks are, you know, things that should not be being dealt with at the legislative level. So I think that it’s not unusual for her to do vetoes and and I think what there’s only been, what three or four so far yet, although, as we talked about earlier, there’s a whole bunch more bills being headed to her desk. But, yeah, the bills that she has been vetoing have been getting overridden, and that happened even before, because she had signed some of those even before they left on Friday. So they were, they addressed some of those then.

Theresa Freed 18:09

Okay, and I am sure there is some strategy already being developed, because they would anticipate that veto happening, but it’s, it’s a process to override a veto. Can you talk a little bit about?

Linda Sheppard 18:21

So, as Val mentioned earlier, when a bill gets passed, that bill goes to the governor, and she has three choices. She can go ahead and sign it right away. She can veto it. Or if she can just wait for 10 days and it will become law, she takes no action and you’re absolutely right, from the from the legislative perspective, you know, when they’re passing bills, I mean, obviously the proponents and opponents are working for their particular position and in each of these bills. But one of the things that is known at the point that a bill does go to the governor is the number of votes that they had in favor of the bill. So that, you know, is the bill going to be veto proof or not? Because if they didn’t have enough people to be in favor of the bill, and she vetoes it, sometimes it changes when they come back for the veto session, but sometimes they know ahead of time, “oh, we’re not going to have enough votes to override it.” So there is some strategy there. And I think obviously, those of us who are watching this, gives us some ideas of, that’s probably going to get vetoed, because she’s talked about it before. And yes, it appears they do, or they don’t have the veto-proof number of votes.

Theresa Freed 19:39

That makes sense. And as you mentioned, veto session, or veto this portion of the session is happening. We’re about a week away.

Linda Sheppard 19:48

Yeah, they’ll be returning on April 9. That’s a Thursday. And right now on the calendar, it says Thursday and Friday, so they may be here for two full days.

Theresa Freed 19:59

Okay. Anything? Else that we want to talk about related to the session at this point?

Linda Sheppard 20:04

The one thing I might want to mention that we’ve certainly focused a lot of attention on here at KHI was there was a bill that was introduced Senate Bill 363, and that bill, I was actually just speaking to a group last night, and I was sort of giving them sort of giving them some of the history on this, several years ago, the Kansas Legislature added a welfare reform committee, and that had not been in existence prior to that time. And then a few years later, after the Trump administration came into office and had its Department of Government Efficiency, so DOGE, everybody became very familiar with that. Shortly thereafter, the Kansas legislature created what we’re now calling COGE, which is the Committee on Government Efficiency on the Senate side. So the Welfare Reform Committee is on the House side, government efficiency committee is on the Senate side, and immediately one of the things that they were looking at was really just this very thorough review of all of the Kansas public assistance laws, and looking at things like eligibility, how renewals are done, you know, how are there exemptions or waivers in these different in these different programs. And so I really saw this bill as something that had been building for some period of time, and it’s like they were doing a lot of their research and learning and trying to understand what the programs were and how they worked. And so we had this bill that was introduced that was going to make a number of changes to how eligibility determinations were done, some data matching that was going to be made available to both the Department for Children and Families and also KDHE, and in conjunction with them, trying to make sure that the people who were getting approved should be approved, that the people that were on the programs were still eligible and qualified for the benefits. And I think those were some issues that they wanted to address, throwing into this now with the passage of HR1, OBBBA, lots of people call it. Last year at the federal level, which also did a lot of this, was looking at all of the requirements for participation in in SNAP and Medicaid. And so the focus really became on SNAP here in Kansas, in these bills that we were looking at. But so this bill came out, made some changes to how often they were going to do, they used the word redeterminations. And so was that, like a renew, a review of your eligibility at that time, or whether that was just sort of some confirmation. I think that word redetermination kind of threw some folks, because it was like, Well, what exactly does that mean? But, and then there were some things that were in the bill that you know. And I think this often happens. Sometimes when the bills are drafted, there are provisions, or there things that are put in there that maybe at the moment that that’s done, we don’t recognize that maybe there were some unintended consequences that can happen with that. Or occasionally we’ll run these situations where something that’s being asked for actually violates federal law, and then so obviously it’s like, well, the state can’t do that because, you know, we’re required to do it this way under federal law. So those kinds of things happen. So I you know, this bill went back and forth through a lot of different changes. And I think in the end, it ended up, this is one of the bills that Val was talking about, 363 was its number through the entire session, until last week, and then it got moved into which is now 2731. But it looks very different from the way it did when it got introduced. And so there are some things in there about continuous eligibility for part of our disabled population. And so that would actually make things easier for them, really. But the there are some requirements for some more data matching going on between DCF and KDHE and some of our other state agencies and offices that would allow them to have information in probably a much more timely manner in terms of whether someone still remains eligible for SNAP or Medicaid or any of the other public assistance programs. So I think that that data matching process probably going to be a big lift for all of those organizations to figure out how to all communicate with each other in a way that’s consistent. So some of those things have to be done on a monthly basis, that share of information, some of those things have to be done on a on a quarterly basis. And so that is kind of a big change, but that bill, I think the the focus really was on how often were those redeterminations going to be made, and how extensive that was, and how long it was going to take. And so the agencies were very involved in trying to help the legislators understand what the process was going to be.

Theresa Freed 24:59

That’s interesting. They have very different systems, and they are involved in the administration of federal programs that have different requirements, and so it’ll be be interesting to see how all that plays out. Alright, well, I do want to promote some of our products, so obviously Health at the Capitol, we’ll continue monitoring what’s going to happen the rest of this session, and then through the summer and next year and all the times after that, but also our Hill to the Heartland products which are focused on things happening at the federal level and how those decisions and policies impact the state of Kansas in a wide variety of ways. So we are distributing information on that, whether it’s kind of what we’re watching digest-style information, or something that’s a little bit more extensive, where we’re taking a deeper look at some of those issues and what the implications are for Kansas. So we encourage you to check those out, And we’ll see you next time. Thanks for joining us for Health at the Capitol. Sign up to receive our emails@khi.org to get a weekly recap of health policy activity during the Kansas legislative session. You’ll also receive our latest publications and information about upcoming events.

Transcribed by https://otter.ai