Category Archives: Health and safety

Kansas losing out by not expanding Medicaid

healthcaregovHow much is Kansas losing out by not allowing a federal expansion of Medicaid? About $820 million over the next three years, according to a study by the White House Council of Economic Advisers. Kansas is also losing out on 3,800 new jobs over the three-year span. And up to 100,000 low-income Kansans are losing out on needed health insurance. Expansion also would save the state money by moving some adults the state now cares for, such as those with mental illnesses, onto Medicaid and by reducing other costs. But neither the financial nor moral arguments for expansion seem to matter to Gov. Sam Brownback and the Legislature.

Still too many Kansans lacking health insurance

doctoroutAbout 359,000 Kansans – or 12.6 percent of the population – were uninsured in 2012, according to a new report by the Kansas Health Institute. The national average was 14.8 percent. In Sedgwick County, the uninsured rate was 15.5 percent. Two-thirds of uninsured Kansans have family incomes above the federal poverty level ($23,050 annually for a family of four in 2012), KHI reported, and more than three out of four uninsured Kansas adults are working. Though the current uninsured rate is not known, more than 57,000 Kansans signed up for health coverage through the insurance marketplace, according to federal data. That total doesn’t include Kansans 26 and younger who are now receiving health insurance through their parents’ plans, as part of the Affordable Care Act. More than 75,000 additional Kansans could be insured if Gov. Sam Brownback and the Legislature would allow a federal expansion of Medicaid.

Sebelius likely exaggerating ACA’s impact

sebeliustestifyFormer Health and Human Services Secretary Kathleen Sebelius said recently that “there are now 22 million people with affordable coverage thanks to the Affordable Care Act, and that’s a big deal and that number will grow.” The 22 million is the total of 8 million people in the insurance marketplace, 3 million young adults who now get insurance through their parents’ plan, 5 million people in ACA-compliant off-market plans, and 6 million additional people receiving coverage through Medicaid. But Washington Post fact-checkers questioned whether off-market plans should be counted and called the young adults total an “iffy statistic.” The newspaper gave Sebelius a “two Pinocchios” rating (out of four).

Pro-con: Was Hobby Lobby ruling correct?

supremecourtbldgSince March 2010, as the Obama administration turned the Affordable Care Act into federal regulations, few provisions grew as controversial as the mandate that most employers provide insurance coverage for contraceptives. The most disputed implication of that mandate, and the one at issue in a major Supreme Court ruling Monday, demanded coverage of contraceptives some employers view as tantamount to abortion because those methods can stop fertilized embryos from implanting in the womb. For many Americans, this so-called Hobby Lobby case (the plaintiffs include that retail chain) is about whether employees have a right under the health care overhaul to employer-provided contraception. Other Americans see the case as a test of whether the government can require companies to be indirectly complicit in abortions. For still others it’s about attacking or defending the Affordable Care Act, aka Obamacare. Five U.S. Supreme Court justices chose a different battleground. In the first sentence of a 49-page opinion, they framed the case as asking whether the 1993 Religious Freedom Restoration Act lets the government demand that closely held corporations “provide health-insurance coverage for methods of contraception that violate the sincerely held religious beliefs of the companies’ owners.” In the very next sentence, the justices ruled that the RFRA’s protections of religious exercise outlaw the Obamacare regs that require such employers to provide the coverage. The ruling is narrowly tailored and, with its numerous qualifiers, doesn’t appear to create the slippery slope threats that the court’s dissenters imagine. Congress and the Obama administration can find ways to provide contraception without involving employers. For lack of that smarter move from the get-go, Obamacare has suffered another wound. We hope a pile of future memoirs explain why the White House didn’t find a less intrusive way of delivering the coverage. This decision angers many Americans. But it’s a logical extension of the Constitution’s intent to make ours a free and pluralistic society. – Chicago Tribune

In ruling 5 to 4 that “closely held” companies can refuse on religious grounds to include contraceptives in their employees’ health plans, the Supreme Court has needlessly interfered with an important provision of the Affordable Care Act. And it has done more than that. The specious reasoning in Justice Samuel Alito’s majority opinion could embolden employers to assert a “religious” right to deny other health benefits to their employees or to discriminate in other ways. And by stretching the meaning of a law intended to protect individuals, the decision threatens to fracture what has been a bipartisan support for reasonable accommodation of religious beliefs. A 1993 federal law, the Religious Freedom Restoration Act, allows a person to opt out of a generally applicable law under some circumstances if obeying it would “substantially burden” the exercise of his or her religion. Alito held, unpersuasively, that Hobby Lobby and the other companies qualified as “persons” and, even more absurdly, that making contraception available to employees who would make their own reproductive decisions was a “substantial burden” on the religious freedom of employers. Bad as it is, the decision could have been worse. The protection it offers is limited to “closely held” companies, sparing the courts from having to determine the religious beliefs of large companies with multiple shareholders and officers. Alito also insisted that the decision didn’t establish a general principle that a company could get around an insurance mandate by lodging a religious objection. But the logic of the decision would seem to cover a wide range of medical services that might offend Jehovah’s Witnesses, Christian Scientists and adherents of other faiths. Beyond the harm it does to women’s access to birth control, this ruling undoes the political consensus that led to the enactment of the Religious Freedom Restoration Act. Battle lines will soon be forming around whether the law should be amended or even repealed. That’s a lot of damage from one misguided decision. – Los Angeles Times

Health centers shocked that state halted initiative

CB060917Community health centers across the state are understandably in shock after the state unexpectedly and at the last minute halted a new health homes initiative. The Medicaid program was supposed to provide wraparound services and close case management to chronically ill low-income Kansans, the Kansas Health Institute News Service reported. The health centers had spent thousands of dollars and hired new staff to get ready. But less than 24 hours before the program was to launch on Tuesday, the Kansas Department of Health and Environment sent a short e-mail saying it was indefinitely delaying the initiative. KDHE said that the network of providers was inadequate and it would re-evaluate after Jan. 1, 2015. But providers said that they aren’t sure they can afford to ramp up again or trust KDHE not to pull the plug. “I’ve lost faith it will ever happen,” said Krista Postai, chief executive of the Community Health Center of Southeast Kansas.

Calling 911 shouldn’t mean being put on hold

phonedialingBecause Sedgwick County can’t predict when the average 1,400 calls a day will come in to the 911 center, it’s not surprising that dispatchers sometimes are all busy. But even if a two-minute wait is unavoidable at times, such delays should not be treated as acceptable by county officials. And as officials work to avoid queuing up 911 callers, residents should think again about whether that 911 call is really necessary. It’s nuts that, as Kim Pennington, director of Sedgwick County 911, told The Eagle, “We have people calling us to get the phone number for the jail, people calling us about what time they have to go to court, calling us asking us when it’s going to quit raining. We had a lady three weeks ago in Derby call because McDonald’s didn’t make her double cheeseburger correctly.”

Kansas needs to get its health back on track

doctorwithchild4As recently as 1991, Kansas ranked as the eighth-healthiest state in rankings compiled by the United Health Foundation. In the current rankings, Kansas is 27th. “That is a huge drop in 23 years,” Kansas Health Foundation president Steve Coen said at a symposium his foundation held last week. Factors contributing to the decline include that Kansans are getting heavier (the state’s 30 percent obesity rate is one of the highest in the nation), fewer Kansas children are being fully immunized, and smoking rates have decreased less in Kansas than in many other states. As Coen said: “Something has gone seriously wrong in the state of Kansas, and we’ve got to do something to get it back on track.”

Brownback shows no interest in Medicaid expansion

doctoroutThough Gov. Sam Brownback says he hasn’t decided yet whether to allow a federal expansion of Medicaid, his comments sound like he has no interest in it. During a recent interview with the conservative Heritage Foundation in Washington, D.C., Brownback said that “Obamacare is not working and it is not going to work.” He also scoffed at the federal government’s promise to cover all of the costs of expansion for the first three years and a minimum of 90 percent after that. “They’re going to up our percent,” he said. Nor did Brownback show interest in alternative models of expansion being pursued by other red states.

Kansas losing out on millions in Medicaid funding

medicaidRep. Jim Ward, D-Wichita, was one of the speakers at a Friday rally at the Statehouse in Topeka supporting a federal expansion of Medicaid in Kansas. Not only have Gov. Sam Brownback and the Legislature refused to allow an expansion, but GOP legislative leaders wouldn’t even allow Ward to have a hearing on the issue this past session. “That is wrong,” Ward said. “This is the place where we have those discussions.” The federal government would pay the entire cost of expansion for the first three years and nearly all the cost after that. By not expanding, Kansas has lost out on about $164 million in federal funding since Jan. 1, according to the Kansas Medicaid Access Coalition.

Strong demand for health insurance in Kansas

healthcarereformDespite all the problems with the federal website, more than 57,000 Kansans signed up for health coverage through the insurance marketplace, according to newly released federal data. What’s more, 31 percent of enrollees in Kansas are between the ages of 18 and 34, which is higher than the national average of 28 percent. The 57,000 total doesn’t include Kansans 26 and younger who are now receiving health insurance through their parents’ plans, thanks to the ACA. More than 75,000 additional Kansans could be insured if the governor and the Legislature would allow a federal expansion of Medicaid. But they are more concerned about trying to undermine the ACA rather than helping needy Kansans gain coverage.

Compact wouldn’t ‘return’ Medicare control to Kansas

doctorswashinghands1Proponents of the multistate health care compact have touted how “it would allow the state of Kansas to once again be back in control,” as Sen. Mary Pilcher-Cook, R-Shawnee, put it. “This is a states’ rights issue of returning health care back to the states,” said Rep. Brett Hildabrand, R-Shawnee, as Gov. Sam Brownback signed the bill last week. That “back-in-control” talk is misleading at best. States have never had a role in providing services and benefits via Medicare, which is the federal health insurance program covering people 65 and older and certain people with disabilities and permanent kidney failure. The Kansas Insurance Commissioner’s Office has a regulatory role relating to Medicare supplemental plans and private companies that have contracted with the federal government to provide Medicare. But the control and authority rest with the federal government. So if the health care compact wins congressional approval, Kansas will be assuming responsibility for Kansans’ Medicare not “again” but for the first time.

States fighting ACA lag in reducing uninsured rates

Doctor Speaking with PatientStates that created their own insurance exchanges and allowed an expansion of Medicaid as part of the Affordable Care Act were three times more successful in reducing their percentages of uninsured citizens than states such as Kansas that did neither, according to a new Gallup survey. “The uninsured rate, on average, declined 2.5 percentage points in the 21 states (plus the District of Columbia) that have implemented both of these measures, compared with a 0.8-point drop across the 29 states that have taken only one or neither of these actions,” Gallup reported. An estimated 75,000-plus Kansans would qualify for health insurance if Gov. Sam Brownback and the Legislature allowed the Medicaid expansion.

GOP hatred of Obamacare may pay off at polls

healthunclesamA recent Kaiser Family Foundation poll found that only Republicans support repealing the Affordable Care Act; a majority of Democrats and independents (and 59 percent of those surveyed overall) favor keeping the law in place and improving it. Also, only Republicans want the debate about the ACA to continue, while everyone else wants the country to focus more on other issues. But don’t expect the debate (and certainly not the campaign ads) to stop anytime soon. That’s because Republicans are passionate in their hatred of the ACA, according to a Pew Research Center poll, and thus are more likely than Democrats and independents to vote in the midterm elections.

Help mentally ill by expanding Medicaid

mentalhealthGov. Sam Brownback’s mental health task force made some good recommendations last week on improving the state’s mental health system, such as having the state offer financial support to preschool and early childhood behavioral health care programs and doing a better job integrating services. But the most cost-effective improvement the state could make is allowing the federal expansion of Medicaid. The expansion, which would be fully paid for by the federal government for the first three years and nearly fully funded after that, would enable thousands of Kansans to receive mental health treatment in their communities.

Brownback should veto bill giving state control of Medicare

praeger“To include Medicare into an attempt to make political statements about the Affordable Care Act, I think, is wrong,”  said Kansas Insurance Commissioner Sandy Praeger (in photo). It is wrong. Yet House Bill 2553 would give the state control of all federal health care programs, subject to congressional approval, including Medicare, Medicaid and the Children’s Health Insurance Program. Brownback needs to veto the bill, which is being promoted by an out-of-state group, and not jeopardize the health care of senior citizens. Praeger also cautioned that there could be political consequences if Brownback signs the bill: “I would be very nervous if I were running in a statewide campaign about making that bloc of seniors upset.”

Delay in alerting residents to water pollution is outrageous

waterfaucetWhat’s even more alarming than the report that the groundwater in several northwest Wichita neighborhoods is contaminated is the news that the Kansas Department of Health and Environment discovered the pollution in 2009. Why didn’t KDHE tell residents about the pollution sooner? Funding used for testing private wells wasn’t made available through the KDHE’s Dry Cleaning Remediation Program until earlier this year. So some residents have been drinking and bathing in potentially cancer-causing water for the past four years because KDHE couldn’t scrape up some money to test a few more wells? That’s outrageous.

GOP candidates support state takeover of Medicare

doctormedicareNot only did the Legislature approve a bill that could put the state in charge of Medicare, but all of the GOP candidates for Kansas insurance commissioner think it is a good idea. Seriously? At a forum in Wichita last week, the four Republican candidates said they supported Kansas joining a compact of states seeking to exempt themselves from federal health care rules. Though their comments focused on the Affordable Care Act, House Bill 2553 would give the state control of all federal health care programs, subject to congressional approval, including Medicare, Medicaid and the Children’s Health Insurance Program. Sandy Praeger, the state’s current insurance commissioner (does she really have to retire?), warned that a state takeover of Medicare “could jeopardize the coverage and benefits that seniors have come to count on.” Senior citizens need to call Gov. Sam Brownback at 877-579-6757 or contact him through his website at governor.ks.gov and tell him to veto House Bill 2553. They, and all other Kansans, also need to think carefully about whom to vote for in upcoming elections.

Some relief for Kansans in seeing Sebelius go

sebeliustestifyFor Kansans who felt some guilt by association during the worst of the passage and rollout of the Affordable Care Act, there is some relief in seeing Health and Human Services Secretary Kathleen Sebelius step down. The former Kansas governor was a smart choice for the key Cabinet post in 2009 because of her experience and her passion for health care policymaking and commitment to covering the uninsured. And Sebelius exits with ACA enrollment at 7.5 million – more than the target. But what an ordeal, including that appalling initial flop of the HealthCare.gov website. Any benefit for Kansas from her status was lost to partisanship, as Republican Gov. Sam Brownback wanted nothing to do with the ACA. Sebelius’ resume is now tarnished and her political career is surely over. Perhaps she will write a book about her experience at the center of the biggest political storm of the Obama presidency. It’s hard to believe now that Sebelius, as governor, had approval ratings in Kansas as high as 70 percent back in 2007.

Pro-con: Does Sebelius leave a positive legacy?

sebeliuslaughingImplementing Obamacare was never going to be easy. And Kathleen Sebelius never had the kind of control a chief executive officer would. She was always dealing with a host of other players. And that’s to say nothing of her war with the congressional Republicans, who were trying actively to sabotage the law through repeal votes, funding cuts, and intimidation of would-be allies. More important, the law seems to be working, despite all of the early problems. Of course, Sebelius can’t take all or even most of the credit for the Affordable Care Act’s improved performance, any more than she should take all or most of the blame for the law’s troubles. Any accounting of her tenure must include such achievements (and others, like improvements to Head Start and stronger regulations on child care safety). To take one obvious example, Sebelius worked extensively with Republican governors who wanted to expand Medicaid in states with hostile conservative constituencies. The memories of Obamacare’s difficult start will certainly linger. But to the millions of people around the country who now have access to affordable medical care, I’m not sure that really matters. – Jonathan Cohn, the New Republic

It’s been quite a year for the former Kansas governor. October brought the failed launch of the HealthCare.gov website, which Sebelius initially characterized as simply the result of surging consumer demand for Obamacare and a “great problem to have.” December brought more embarrassing news as Sebelius waived the law’s individual mandate to buy insurance by categorizing Obamacare itself as a hardship worthy of exemption. This was just one of many on-the-fly rewrites the administration claimed the authority to make under a law passed by Congress and signed by the president. Though she is leaving now, her legacy is secure, as her name adorns several of the most consequential federal cases resulting from the law. Her resignation doesn’t change the fact that Democrats will remain politically accountable for a law sold on a fraudulent promise from President Obama. But this latest news does mean that not even the secretary of health and human services will get to keep her insurance plan. – James Freeman, Wall Street Journal

Now even harder for GOP to repeal Obamacare

healthcaregovpageThe more than 7 million Americans who signed up for Obamacare (along with millions more who gained insurance through their parents or through expanded Medicaid) make “it highly unlikely that Republicans will be able to deliver on their promise to repeal the law,” columnist Doyle McManus wrote. It would be very hard to take insurance away from that many people. But, McManus wrote, “that doesn’t mean Obamacare is guaranteed to succeed. The program still faces a series of difficult tests – most important, keeping costs under control so insurance premiums don’t soar in coming years.”

Pompeo convinced that GM foods are safe, needed

food“The science is clear” that genetically modified foods are safe, Rep. Mike Pompeo, R-Wichita, told The Eagle editorial board. Pompeo introduced a bill this week that would require that new GM foods be reviewed by the U.S. Food and Drug Administration; currently, such review isn’t mandated. The bill also would give the FDA sole authority on whether to label GM foods – barring states from imposing their own regulations. Supporters of labeling argue that it informs consumers, but Pompeo contends that a patchwork of unscientific state regulations creates burdens and barriers for Kansas farmers. “It’s a big deal to our growers,” Pompeo said.

Kansas gets costs, not benefits, of expanded Medicaid

healthcaregovOne of the projected costs of expanding Medicaid is the “woodwork effect.” It refers to people already eligible for Medicaid who come “out of the woodwork” as they learn about the program. But this effect happens even in states such as Kansas that refuse to expand Medicaid, because of all the publicity about the Affordable Care Act. Kansas’ enrollment in Medicaid and the Children’s Health Insurance Program increased to 415,284 in February, up more than 17,000, or 4.3 percent, from monthly averages before the launch of the ACA insurance marketplace. So Kansas’ costs are increasing, but it isn’t receiving the financial benefit of expanding Medicaid.

ACA working despite efforts of ‘haters’

healthcaregovpage“It has been obvious for some time now that the great fear among these politicians and conservative pundits was not that Obamacare would fail but that it would succeed,” wrote columnist Bob Ray Sanders. “I can only imagine how they must feel after watching people line up around the country Monday in an attempt to register for health care on the last day of enrollment, and to see the number of participants swell over the 7 million mark.”

Legislature doesn’t want ACA to work in Kansas

healthcarereformEven after its disastrous rollout, the Affordable Care Act exceeded projections and enrolled 7.1 million Americans in private insurance plans by Monday’s deadline. This is on top of the more than 3 million adults younger than 26 who were added to their parents’ insurance plans, and on top of the millions who gained coverage through Medicaid expansion. “It’s working. It’s helping people from coast to coast,” President Obama said. But state GOP legislators are still determined to keep the ACA from helping low-income Kansans. The Kansas Senate voted last week to prohibit the state from expanding Medicaid unless the Legislature approves. And the House approved a bill to remove Kansas from the ACA (and potentially Medicare) and join a multistate compact.

ACA saving seniors on prescription drugs

drugsSince enactment of the Affordable Care Act four years ago, Kansas seniors and people with disabilities on Medicare have saved nearly $94 million on prescription drugs, according to a new report from the U.S. Department of Health and Human Services. Closing the “doughnut hole” in Medicare Part D has saved about 40,500 Kansans nearly $32.5 million, for an average savings of $800. Nationally, ACA has saved seniors $9.9 billion on prescription drugs, according to HHS.