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Health care a priority as Legislature wraps up

BY KAREN SHIDELER

The Wichita Eagle

About half of a group of proposals to deal with Kansas' health care problems could be implemented this year, a result that some see as failure and others greet as success.

The proposals include expanding the state health insurance program for children, providing dental care for low-income pregnant women, and implementing a statewide Community Health Record, a patient database of medical information.

Final action on the health reform proposals will be one of the major tasks awaiting legislators when they return to Topeka for their wrap-up session on Wednesday. A conference committee is to craft a compromise bill from the House and Senate versions of the reforms.

The reforms were proposed by the Kansas Health Policy Authority, created by legislators two years ago and charged with developing solutions to Kansas' health care problems. In November, the authority gave legislators 21 recommendations, including a statewide public smoking ban and a cigarette tax increase. Neither of those made it to the conference committee.

The cost of the compromise proposals being considered is about $9 million, a figure that could make acceptance difficult in a year where legislators are faced with revenue estimates that are less than had been expected.

Some of the proposals

During a recent meeting with Kansas health journalists, Gov. Kathleen Sebelius expressed frustration with what she sees as a lack of action on health care. Neither of the smoking reforms would have required new revenue, she said, but legislators lacked the political will to consider them, though statewide polls show that a majority of Kansans support them.

Both chambers supported expanding HealthWave, to provide medical care for more Kansas children, but the action "is a totally hollow vote," she said, because it depends on additional federal funding, which isn't available.

House Speaker Melvin Neufeld, R-Ingalls, and Sen. Jim Barnett, R-Emporia, were more positive about the work that has been done, and said they thought a compromise bill would have a good chance of passage.

"Anything big doesn't happen instantly, doesn't happen in a 90-day session," Neufeld said, but the steps taken are a good start.

Barnett, a physician who has championed many of the health care reforms, said it took legislators years to deal with school funding, and he predicted that meaningful health reform will take a similar long-term effort.

"There are many who want to maintain the status quo," he said, and "money and special interests have tremendous influence" on policy.

An 'incremental process'

Marcia Nelson, executive director of the Kansas Health Policy Authority, took a middle-of-the-road view.

"We have always known that this would be an incremental process," she said. Expanding Medicaid to more pregnant women, providing dental care for them and implementing the Community Health Record would be a good start, she said. But she echoed Sebelius in calling legislators' efforts to expand HealthWave "an empty promise."

These are among the provisions expected to be part of the final compromise:

• Expand children's eligibility for HealthWave to those whose families earn up to 250 percent of the federal poverty level. For a family of three, that would be an annual income of $44,000. The expansion would be contingent on increased federal funding through the State Children's Health Insurance Program.

• Create a premium assistance program for low-income parents, to purchase job-based insurance for their families if it is available and if the children would otherwise be eligible for HealthWave. Employees' contributions would range from $40 to $90 a month, depending on income.

• Provide dental care and tobacco-cessation programs for pregnant women on Medicaid.

• Expand the number of pregnant women eligible for Medicaid.

• Implement a statewide Community Health Record. Sedgwick County has been piloting a program, which tracks health care data of Medicaid patients among 20 providers, since early 2006.

• Expand cancer screenings, through rural health clinics and safety net clinics.

Reach Karen Shideler at 316-268-6674 or kshideler@wichitaeagle.com.