TOPEKA — The state should not spend new money to provide services to developmentally disabled Kansans on waiting lists unless they are included in the state’s new privatized Medicaid system, a Republican-dominated House panel decided Thursday.
The move by the House Appropriations Committee was part of ongoing budget talks and could be changed away as negotiations continue.
But it came a day after about 1,100 people with disabilities and their supporters marched throughout the Capitol seeking to keep their long-term state services independent of the new KanCare system. They say they are concerned private insurers won’t provide adequate services to help them live more meaningful and productive lives.
Republican Gov. Sam Brownback has proposed spending about $16 million of $67 million in unexpected state savings generated by Medicaid reform over about two years to take a few hundred of the roughly 5,000 Kansans with physical or developmental disabilities off waiting lists for services.
Savings generated from adding developmentally disabled Kansans to KanCare are needed to afford reduction in the waiting lists, said Rep. Dave Crum, R-Augusta.
“And the reason we’re going to capture those savings is we’re going to have better health outcomes,” Crum said. “We’re going to see fewer hospitalizations, fewer mental health issues that require institutionalization and overall our developmentally disabled population is going to be healthier.”
Rep. Marc Rhoades, R-Newton, said leaving developmentally disabled Kansans outside of the KanCare system means forgoing projected savings that could be used to buy down waiting lists.
“It kind of works against itself,” he said.
Democrats and some Republicans fumed at the move.
Rep. John Rubin, R-Shawnee, said he believes there are now enough votes in the House to keep long-term care services for developmentally disabled Kansans outside of the KanCare system for another year.
“To be told that we have to do that at the cost of any chance at reducing the waiting list is a heck of a choice for us to have to make here,” he said. “And I don’t know how I’m going to make that choice personally, or how a lot of us are.”
Rep. Nile Dillmore, D-Wichita, said it’s an “extortion type of move” to threaten new money for the waiting lists. It’s unlikely privatized systems would produce better outcomes because developmental disabilities are usual permanent and the services are intended to provide better quality of life – not necessarily fewer hospital visits or major rehabilitation, he said.
Rep. Jim Ward, D-Wichita, who has spearheaded efforts to keep developmentally disabled Kansans outside of the KanCare system, said the move doesn’t make sense.
“The governor has been making a big deal for the last month and a half about all the savings they’ve already got from KanCare,” Ward said. “So which is it, we have a lot of savings we can use? Or do we have to do it on the backs of Down’s syndrome kids and autistic kids?”
Brownback declined to comment directly on the committee’s decision Thursday afternoon because he hadn’t yet reviewed it.
“I think we ought to buy down the waiting lists, and that’s what we put forward off of the KanCare dividend,” he said. “The program is working.”
In a prepared statement later, Brownback’s spokeswoman, Sherriene Jones-Sontag, said the governor believes reducing waiting lists is “directly tied” to including long-term care and support services for developmental disabilities in the KanCare system. She said estimates prepared for the administration show that not including those services via private insurance companies would cost the state an additional $25 million over two years.