By Gene Meyer

 The U.S. Supreme Court is set to rule on the controversial federal health-care law, probably early next week.

No matter, Kansas lawmakers say.

They have no intention of altering their plan to have private companies run the state’s $1.1 billion Medicaid program, the state’s chief medical officer says.

The court will rule whether the Patient Protection and Affordable Care Act of 2010, informally known as Obamacare, violates the U.S. Constitution by requiring people to buy health insurance. Nearly two dozen states, including Kansas, contend federal officials are overstepping those constitutional bounds.

The court could uphold the law, overturn it, or just change parts of it. Any of those outcomes could alter the rules and funding for Medicaid, the state’s largest single health insurance plan, providing coverage for some 300,000 low-income women, children, seniors and people with disabilities.

“We’re making our plans on the assumption that the Affordable Care Act won’t be there,” said Dr. Robert Moser, Kansas Department of Health and Environment secretary.

Kansas is seeking a solution for containing Medicaid costs, whatever the Court rules, he said.

Specifically, Kansas is seeking federal permission – a waiver –  to abandon Medicaid’s traditional practice of using tax money to pay doctors, nurses and other professionals directly for care given Medicaid patients.

In its stead, state officials propose using a system they’re calling KanCare.

Under KanCare, Medicaid patients would join a managed-care company, hired by the state with the responsibility of coordinating patient treatments and contracting with providers to provide the help for a fixed cost, whatever that may be. 

Five managed-care companies are bidding to become one of the three hired to run the program, Moser said.

Kansas’ share of its joint state and federal Medicaid expenses now runs about $1.1 billion a year, or 18 percent of the state’s general fund budget, and was projected to increase by at least 6.6 percent annually for five years. Each of the proposals from the managed-care applicants would slow growth to below that 6.6 percent level and reduce projected spending by $368 million through 2017, Moser said.

So, whatever the Supreme Court rules, “KanCare won’t be changed,” Moser told Kansas Reporter.

Some Medicaid users and their families are skeptical of the proposed changes.

Joe Michaud is executive director of Developmental Services of Northwest Kansas in Hays. He told a Kansas Department of Health and Environment hearing June 20 that preparing to suddenly turn the process over to private companies, which haven’t yet been chosen, is unsettling, particularly after two decades of negotiating care contracts in public.

Developmental Services is a nonprofit organization that provides support for 500 children and adults with mild to severe disabilities in northwestern Kansas.

“Don’t gamble with our money,” Michaud said at the hearing.

Dick Wilson, an activist and former director of AARP Kansas, said members of his organization “have some real concerns about transparency” regarding the new proposals.

None of the documents Kansas has filed on KanCare’s behalf provide sufficient detail about what the new program might cost users or how the care users would receive would differ from what they get now, Wilson said. 

“There are very few specifics that show how this change will actually improve service,” Wilson said.

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