TOPEKA — Topeka adoptive and foster-care parent Kathy Keck pulled the microphone close Wednesday to make certain everyone at the Capitol captured depth of the despair in her voice about the Medicaid program in Kansas operated by three for-profit companies.

Her decision to reveal to the Legislature’s oversight committee on KanCare personal struggles with the $3.3 billion program serving 415,000 Kansans wasn’t made lightly. She chose to push aside anxiety the lives of her three children could be harmed through retribution by state agencies, private contractors or others. She declined to allow fear to silence honest discussion of her journey in the KanCare system.

“Retaliation can happen,” said Keck, who was joined at the hearing by one of her disabled children. “I am their voice. My children are not numbers. They are not their diagnosis. They’re not second-class citizens.”

Keck said a recent source of frustration was denial by Sunflower Health Plan of a special bed for a child with traumatic brain injuries. The decision was rescinded by Sunflower less than a week before Keck was scheduled to deliver public testimony to the committee in Topeka.

“She will get a hospital bed,” said Chris Coffey, president and chief executive officer of Sunflower. “It’s never easy, especially when dealing with a very fragile child.”

In terms of retaliating against Keck for exercising free speech rights on the subject of Medicaid, Coffey said, “never has happened and never will.”

Sen. Vicki Schmidt, R-Topeka, and Rep. Barbara Ballard, D-Lawrence, urged Keck to notify members of the oversight panel if reprisals occurred as a consequence of her testimony.

“They will know what retaliation is,” Ballard warned.

Gov. Sam Brownback and Lt. Gov. Jeff Colyer, who instigated the privatization effort for Medicaid, have concluded the transition improved medical outcomes for low-income adults, pregnant women and people with physical and developmental disabilities.

One member of the Legislature’s oversight committee said he was among fans of the overhaul.

“Pre-KanCare was a nightmare. KanCare, for us, has been fabulous,” said Rep. Chuck Weber, a Wichita Republican who has a son with a developmental disability.

Brownback and Colyer, who will become governor upon resignation of Brownback to take a job in the administration of President Donald Trump, said the state saved more than $1.4 billion since 2013 by curtailing cost increases of Medicaid in Kansas. The state still has waiting lists of disabled people who qualify for benefits but don’t receive those services through KanCare.

“Some days,” Keck said, “it seems we’re more concerned about saving a buck than saving a life.”

Keck said the Medicaid system operated by Sunflower, Amerigroup and UnitedHealthcare was plagued by lack of nursing staff to care for medically vulnerable children in the home to help avoid unnecessarily long hospital stays.

Paperwork and red tape tied to prior authorization of services makes medical providers reluctant to take on people in KanCare, she said.

Keck said a conflict of interest exists because Medicaid care coordinators, who traditionally served as advocates of parents and guardians, are employed by the same managed-care companies denying benefits.

The three MCOs hired by the Brownback administration increased denials for supplies and services, she said, and rejection letters asserted proposals from caregivers were simply a search for convenience rather a medical necessity for a disabled individual.

“There’s nothing convenient about lifting a 130-pound child in and out of a wheelchair,” Keck said.