More federal money would be steered toward Kansas under the latest version of the Senate’s health care proposal.
An additional $60 million a year over eight years would go to Kansas hospitals with the greatest percent of low-income patients. The change comes from how funding is determined for those hospitals, calculated by the number of uninsured people in the state rather than the number of Medicaid enrollees.
“The intention seems to be to provide additional support for hospitals and states that didn’t expand Medicaid,” said Kari Bruffett, director of policy at the Kansas Health Institute.
Most hospitals are eligible for at least some of these payments, Bruffett said. The goal would be to offset uncompensated care at the hospitals.
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Sen. Pat Roberts said he has been working with Senate leadership since the first draft was released to ensure Kansans have more coverage options and that providers in rural areas will continue to be supported.
He said Thursday that he had advocated for additional funding for states that did not expand Medicaid.
“For those Kansans struggling to make ends meet, this bill provides additional assistance to purchase insurance on the private market and gives states and insurers funds to ensure plans are affordable and that patients can access the care of their choice,” Roberts said in a statement.
Sen. Jerry Moran, who opposed the previous version of the bill, is analyzing the changes to see how they affect Kansans, according to his office.
‘Drop in the bucket’
Cindy Samuelson, vice president of public relations and political fundraising at the Kansas Hospital Association, said the changes aren’t enough. “Although we appreciate the Senate’s effort to close the gap for non-expansion states, the additional funds are hugely inadequate and do not compare to the dollars afforded to expansion states,” she wrote.
The latest draft would also give states with lower population density, like Kansas, priority when it comes to competing for incentive payments for home- and community-based services for people with disabilities. The draft calls for a pilot program from 2020 to 2023 for states to make payment adjustments for those services.
The total amount that could be allotted to eligible states under the program is $8 billion.
Rocky Nichols, executive director of the Disability Rights Center of Kansas, said the money would be a “drop in the bucket” even if the state were selected. Kansas now uses $600 million per year in federal funding on home- and community-based services, he said.
“This is like a spoonful of sugar to get the Senate to gulp down a bottle of cyanide when it comes to Medicaid,” Nichols said.
Roberts said the reforms to Medicaid “are not a cut” but simply slowed growth.
“We’re trying to redirect the program back to its original purpose providing care to the most vulnerable populations,” he said.
The bill also comes with an additional $45 billion to combat opioid misuse. However, states will be given the option to use the money on other substance use such as methamphetamine, which is more common in Kansas.
Similar to early version
David Jordan, executive director of the Alliance for a Healthy Kansas, said in a statement that the changes “do little to alleviate the harm the plan will wreak on Kansas.”
“The Senate plan will still result in hundreds of millions of dollars in Medicaid cuts for Kansas,” Jordan said. “These cuts will reduce access to services for children, people with disabilities, and seniors in nursing homes. Kansas’ budget, health care providers, and residents cannot afford these cuts.”
Much of the bill remains similar to the earlier version. Both would reduce payments to Medicaid and no longer penalize people for not having insurance.
“The revised plan will still result in hundreds of millions of dollars in Medicaid cuts for Kansas,” wrote Samuelson.
Another significant change is one advocated by Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah. The amendment would allow insurers to sell plans that do not meet certain regulations as long as they offer another plan that does.
Opponents to the amendment say this could create a split pool: people with greater health care needs on the Affordable Care Act-compliant plans and younger, healthier people on the noncompliant plans. This could potentially increase the cost of the compliant plans, since they would be used by people with greater needs.