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Kansas Considers Health Reform Options

By Kelley Weiss

http://stream.publicbroadcasting.net/production/mp3/kcur/local-kcur-648829.mp3

Kansas City, MO – After months of planning the Kansas Health Policy Authority will present health reform recommendations to Governor Kathleen Sebelius and the Legislature today, Thursday, Nov. 1. With talks of universal coverage swirling and more people than ever living without insurance people across the state are watching this proposal. If the Legislature implements these recommendations it's estimated that thousands more Kansans would get health insurance. KCUR's Kelley Weiss reports.

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Across the country states are presenting reform plans to address rising health care costs, the uninsured and declining health. Earlier this year, in Kansas, lawmakers asked the Kansas Health Policy Authority, or KHPA, which was created by the Legislature, to draft a plan for health reform. KHPA will now present 21 recommendations to the governor and Kansas Legislature. The main themes of this reform: encouraging personal responsibility, prevention and expanding insurance for the poor and small businesses. KHPA Executive Director, Marci Nielsen.

Marci Nielsen: "What we're trying to do is get Kansans healthier and get them access to a health insurance system that promotes health."

Nielsen says the "medical home" is an important part of the reform. This concept creates a comprehensive home for patients emphasizing prevention - where they have a centralized system for care coordinating their records and doctors. Nielsen also points to the premium assistance proposal to subsidize more low-income Kansans to buy private health insurance. She estimates if the state agrees to offset these costs it could provide coverage to 110,000 more people. She says if this happens Kansas would be a leader in the country for reducing the number of people without insurance.

Marci Nielsen: "Knocking out a third of the uninsured in our state puts us right at the top of the list."

Nielsen also says another key recommendation is encouraging small businesses to use pretax dollars to pay for health insurance as well as using a state clearinghouse for coverage. And another focus is on improving health literacy and helping providers use more online technology for care.

The annual price tag of the recommendations is around $86 million. A high priority of KHPA is the recommendation of a tobacco tax increase to pay for about $52 million of the expense. Some critics are skeptical that the Legislature will pass a tobacco tax increase -- similar efforts have failed in the past. But Nielsen contends that smoking is the number one cause of preventable death in Kansas and should have a more substantial user fee. KHPA also wants a statewide ban on smoking in public places.

Corrie Edwards: "It could've been worse but it started out a lot better."

That's the executive director of the Kansas Health Consumers Coalition, Corrie Edwards. She says many health care advocates are disappointed by the tone of the recommendations.

Corrie Edwards: "We're now instead of using words like mandate and require we're now using words like voluntary, targeted outreach and assisting, that kind of thing. And to me those words are watered down because they're not tangible."

In the beginning of the reform process, she says, the options were much more promising and included mandating insurance for all children. But, she says, unfortunately that's not how things work around here.

Corrie Edwards: "We're not all about subsidizing stuff here in Kansas. We're very much a pick yourself up by your bootstraps and get yourself out there. And, you know, we're not about mandates. We do not like to be told what to do."

Associate professor of health policy at the University of Kansas Medical Center, Michael Fox, says the expectations were high when KHPA started working on the reform. In Governor Sebelius's State of the State address this year, she said she wanted all Kansans to have health insurance, particularly children. Although, Fox says the reform recommendations will not cover all Kansas kids, but will instead focus on enrolling the some 40,000 children eligible for Medicaid and Health Wave coverage.

Michael Fox: "I'm as disappointed as anyone that we're not demanding universal coverage not just for children but for everyone. But it's a simple fact that our Legislature will simply not buy that and they won't even discuss that. This at least keeps things on the table and I think this positions us better than many other states that are taking a more confrontative approach and probably will be left with nothing."

Kansas Republican Senator from Emporia and doctor, Jim Barnett, says the policy authority approached this in the right way.

Jim Barnett: "I think they've done a good job of bringing forward something that is practical, sensible and pragmatic and something that we can advance."

Barnett is a leading voice on health care reform at the capitol in Topeka and says it's likely that many of these recommendations will make it into a health care bill that lawmakers will debate. One big question at this point, he says, is how the reform will be paid for. He says there's only a remote chance lawmakers will go for an increased tobacco tax and also thinks the smoking ban will fail.

But, as Marci Nielsen of KHPA says, funding and details of the recommendations will have to be worked out by lawmakers - she says this is the first step in a series of health reform.

Funding for health care coverage on KCUR has been provided by the Health Care Foundation of Greater Kansas City.

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