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Details of Kansas’ new bipartisan plan

Topeka Capital Journal - 1/10/2020

Gov. Laura Kelly, D-Topeka, and Senate Majority Leader Jim Denning, R-Overland Park, revealed Thursday a bipartisan proposal to expand eligibility for Medicaid health services to 130,000 to 150,000 Kansans.

The Medicaid program serves 340,000 low-income, elderly and disabled people in Kansas. It costs $3.8 billion annually, with the federal government paying the bulk. Kansas statute forbids non-disabled adults without children from qualifying for Medicaid. State law also says adults with children must have incomes well below the federally set poverty level to be eligible.

The 2020 Legislature, which convenes Monday, is certain to consider the compromise package. Debate will likely start in the Senate.

Details of the Denning-Kelly compromise:

• Fully expand Medicaid to 138% of the federal poverty level with the standard funding division of 90% federal and 10% state. Implementation by Jan. 1, 2021.

• Assess a maximum $35 million annual surcharge on hospitals starting July 1, 2021, to support state investment

in Medicaid expansion. The fee was endorsed by the Kansas Hospital Association.

• Make new participants in the expansion population pay monthly premiums of up to $25 per month or $100 per month for a family of four. Failure to make a payment wouldn't lock people out of the Medicaid.

• Create a "reinsurance" program by Jan. 1, 2022, to subsidize insurance rates of Kansans struggling to pay premiums in the private health insurance marketplace. This would require approval of the federal Centers for Medicare and Medicaid Services and consent of the State Finance Council.

in Medicaid expansion. The fee was endorsed by the Kansas Hospital Association.

• Make new participants in the expansion population pay monthly premiums of up to $25 per month or $100 per month for a family of four. Failure to make a payment wouldn't lock people out of the Medicaid.

• Create a "reinsurance" program by Jan. 1, 2022, to subsidize insurance rates of Kansans struggling to pay premiums in the private health insurance marketplace. This would require approval of the federal Centers for Medicare and Medicaid Services and consent of the State Finance Council.

• Establish a referral program within state agencies to direct unemployed Medicaid beneficiaries to employment training or job vacancies. There would be no work mandate to enroll in Medicaid.

• Form an advisory committee in the Kansas Department of Health and Environment to help rural hospitals assess viability of new delivery models or strategic partnerships aimed at improving access to health care in communities.

• Terminate the Medicaid expansion program in Kansas if the U.S. government lowered the federal match below 90%.

• Require the Kansas Department of Corrections to collaborate with county sheriffs to have more medical treatment of inmates covered by Medicaid.

• Direct the Legislature's post-audit division to complete an economic-impact analysis of Medicaid expansion within two years of launch.

• Assign the Kansas Department of Insurance responsibility for reporting to the Legislature on any cost shifting among hospitals and commercial insurance plans as a result of Medicaid expansion.

Tim Carpenter, The Topeka Capital-Journal

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