TOPEKA, Kan. (AP) — Kansas shouldn’t let fear of change prevent it from overhauling Medicaid, an influential legislator said Tuesday, as Gov. Sam Brownback’s administration stuck with plans to let private companies manage the $2.9 billion program starting next year.
House Appropriations Committee Chairman Marc Rhoades, a Newton Republican, responded to criticism that the Brownback administration is moving too quickly to make massive changes in the state’s health coverage for the poor, the disabled and elderly. Rhoades said the state can’t sustain its current Medicaid program because of rising costs.
“We don’t want fear to lock us into doing nothing,” Rhoades told The Associated Press. “At some point, you have to pull the trigger.”
Lt. Gov. Jeff Colyer, who led the team that developed Brownback’s overhaul plan, said Monday that companies have shown “vigorous” interest in becoming contractors. Colyer, a surgeon, made his remarks during a dinner gathering that Brownback had with a bipartisan group of two dozen lawmakers at his official residence.
Brownback’s administration plans to issue three contracts this year for the Medicaid program. Each contract would start Jan. 1, 2013, and each company would operate statewide, giving Medicaid clients a choice of coverage. Colyer said the administration expects to award the contracts this summer.
The overhaul represents the first time the state has attempted to cover the disabled and the elderly, including those in nursing homes, with a managed-care program.
Potential contractors had until Jan. 31 to submit the technical details of their proposals to the state, and they have until Feb. 22 to submit the rest of their materials. Fifteen companies qualified to bid by attending a mandatory state conference for potential contractors in December, but the state’s largest health insurance company, Blue Cross and Blue Shield of Kansas Inc., announced last week that it will not submit a proposal.
The Department of Administration declined a request from The Associated Press for a list of the remaining potential bidders, citing provisions of the Kansas Open Records Act that allow government agencies to keep confidential data “in the process of analysis” and records related to sealed bids.
But Colyer said “multiple organizations” are pursuing the contracts.
State medical programs provide services for an average of 380,000 people a month, and the bulk already receive state health coverage through private contractors. By bringing the disabled and elderly into a managed-care system, the state would add Kansans who need relatively expensive long-term services.
Administration officials have said the overhaul will lead to better coordination of services for high-need Medicaid participants and will eliminate duplication. They expecting that coordinating care will save the state tens of millions of dollars.
But some legislators and advocates, particularly for the disabled, have worried that the state is moving too quickly to overhaul the Medicaid program. Sen. John Vratil, a Leawood Republican, said he’s concerned that the contracts will go to out-of-state companies that could then have only six months to connect with the state’s health care providers.
“I don’t know how they’re going to set up a network or do anything else,” he said.
Anna Lambertson, a lobbyist for the Kansas Health Consumer Coalition, noted that the federal government hasn’t yet waived rules that would block Kansas from covering the disabled and elderly in managed care and include financial incentives for improving services while controlling costs. The state has outlined its concepts to federal officials and expects to negotiate the terms of a waiver in coming months.
“The whole timeline is pretty quick,” she said. “I think there are a lot of unanswered questions.”
But Colyer told legislators Monday that the administration sees the Medicaid overhaul as a two-year process; work began almost as soon as Brownback took office in January 2011.
Rhoades acknowledged the concerns about the timetable but said legislators won’t know how well the changes work until they’re in effect.
“We’re hopeful that the system will work as it’s intended to work,” he said.