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KanCare proposal deserves a closer look

In Kansas, Medicaid primarily serves the health care needs of 360,000 children, elderly and developmentally disabled individuals. The state invests $2.8 billion in tax dollars to administer Medicaid services through the Department of Social and Rehabilitation Services and the Department on Aging and Disability Services.

KanCare is an initiative of the governor to reform the Medicaid system in Kansas. It is envisioned to extend managed care to virtually all Kansans enrolled in Medicaid. The vision statement states, "To serve Kansans in need with a transformed, fiscally sustainable Medicaid program that provides high-quality, holistic care and promotes personal responsibility."

The Kansas approach would be based on the themes of integrated, whole-person care, preserve or create a path to independence and alternative access models and an emphasis on home- and community-based services. This has not been without controversy because of the rapid implementation.

KanCare would privatize Medicaid. Under the KanCare initiative, those funds would be redirected to a private, for-profit and probably out-of-state insurance company. That insurance company then would be responsible for administering services. A red flag on this decision was signaled by Blue Cross/Blue Shield of Kansas when they decided to bow out on the Medicaid makeover.

Tax dollars would be used to fund KanCare. This should require legislative oversight especially since the Legislature is responsible for the budget. With that in mind, it seems the governor cannot be allowed to just write a check for his Medicaid reform, especially when we are talking about billions of taxpayer dollars.

A bipartisan group of House and Senate legislators last week introduced a resolution urging the governor to delay implementation of KanCare until July 1, 2013, giving time to ensure there would be a smooth transition of quality services following all participants.

There is particular concern about this plan's impact on the developmental disabilities waiver population. Families and advocates for those with developmental disabilities have expressed that such a move could lead to cuts in home- and community-based services. Currently, 4,800 Kansas adults and children remain on the developmental disabilities waiver waiting list. The administration is unclear as to how this backlog will be addressed under the KanCare contracts.

Evidence from other states indicates the managed care process has caused serious problems for service providers and recipients. Lawmakers in Kentucky have heard how complicated the new system is for health care providers to get paid. Providers -- hospitals, home-based services, physicians, pharmacists, etc. -- are expressing legitimate concerns. There again is an example of the need for taking the time to put a reformed system in place with a smooth transition.

I agree with a number of my colleagues that the Medicaid plan seems to be following a pattern in the Brownback administration of pushing through "reforms" before fully considering the details or consequences of the action. It is not wrong to look at different ways of doing things, but it is important to take the time to work through potential problems before making changes that will have a profound impact on thousands of Kansans.

President Dwight Eisenhower said it clearly, "Plans are nothing; planning is everything."

Eber Phelps represents the 111th House District. eber.phelps@house.ks.gov