State health officials received a lot of feedback, nearly all of it negative, at a public meeting Monday in Wichita about Gov. Sam Brownback’s plan for Medicaid.
Several hundred people attended the meeting at Wichita State University’s Hughes Metropolitan Complex, 5015 E. 29th St. North, and 36 spoke out about the plan as Robert Moser, secretary of the Kansas Department of Health and Environment, and Shawn Sullivan, secretary of the Department on Aging, listened.
Brownback’s plan, called KanCare, would move nearly all of the state’s 380,000 Medicaid beneficiaries into managed-care plans run by private insurance companies beginning Jan. 1. State officials have said that will slow the growth of Medicaid costs and save the federal and state governments more than $850 million over five years while improving health outcomes. Five insurance companies have bid for three state contracts.
None of the speakers favored the idea.
The audience included many disabled people, their caregivers, other health services providers, and parents of disabled children. Those who spoke either expressed concerns and doubts about the plan, or condemned it.
Many said they were opposed to turning over the health care of low-income, high-risk patients to for-profit companies.
One speaker called it “potentially catastrophic.” Another said companies would reduce services and increase costs, knocking people out of the Medicaid system.
“I wish the state would look at it through our eyes,” said one woman, who said she is Medicaid recipient. “They only look at it from the outside. That’s not how we see it.”
“It’s not family-friendly,” said another woman who identified herself as the mother of a 31-year-old son with autism. She worried that the insurance companies would force her son off medications that have proven effective.
Other parents of disabled children worried about how the new system would affect their children’s complex mix of home and hospital services, and whether they would lose their current providers.
Others pointed to problems in states like Kentucky and Nebraska, where efforts to use private companies to manage health care have struggled.
Many thought the Jan. 1 implementation date was too rushed. One woman wondered why the state didn’t try a pilot project in a small area first rather than immediately impose KanCare statewide.
Although the state has already granted a one-year delay in implementing KanCare for the long-term care of developmentally disabled Kansans, some thought a year wasn’t enough time for a smooth transition for that kind of care.
Sullivan replied that there would be penalties, reporting mechanisms and pay-for-performance measures in place to assure that the companies would provide needed services.
He said stakeholders and health organizations had input into the plan.
He also referred people to the KDHE website, kdheks.gov, where many of the speakers’ concerns are addressed.
The public hearing was part of a process the state must go through to implement the plan. It must re-submit a so-called section 1115 Medicaid waiver to the federal Centers for Medicare and Medicaid Services. A waiver application the state submitted April 26 didn’t have input from two Indian Health Services centers, and the application was filed one day before new federal transparency regulations requiring the state to hold two public meetings became effective..
The second public meeting will take place Wednesday in Topeka. The state plans to re-submit its waiver application in July.
Sullivan said in an interview after the meeting that the feedback from the two public meetings would be used to help the state come up with an educational campaign for KanCare before it goes into effect.
“We need to make sure we are easing their minds that they’re going to be able to keep their current providers, and they won’t lose their services,” he said.
Sullivan said the Centers for Medicaid and Medicaid Services has told the state that there’s no reason that the resubmission of the application would delay the Jan. 1 implementation of KanCare.