Kansas House, Senate Must Resolve Who Gets State Aid on Health

Legislators are committed to modest health care improvements, but the House and Senate disagree about which uninsured Kansans should get help from the state.

The House approved a bill Tuesday on a 103-20 vote to provide a year’s worth of state aid to help poor parents buy private insurance. Supporters believe about 8,500 individuals who don’t have coverage could get it.

Senators approved their bill last week. Instead of providing insurance subsidies, it would expand a state program that depends on federal funds to cover children’s medical expenses. About 5,500 additional children in middle-class families would become eligible.

Another proposal before the Senate would increase spending on 33 “safety net” clinics by $1.5 million, allowing them to serve an additional 5,200 people at little or no cost.

The Senate refused to include the insurance subsidies in its bill. House members rejected the Senate’s proposal to expand the state’s medical coverage for children.

“It’ll be on the table with all of the House’s moving parts when we sit down to negotiate,” said Senate Majority Leader Derek Schmidt, an Independence Republican.

Three senators and three House members will draft the final version of the health care legislation. Neither chamber has embraced a sweeping, 21-point plan proposed by the Kansas Health Policy Authority and endorsed by Gov. Kathleen Sebelius.

Legislators created the authority in 2005 to review health care issues and administer some social services programs. Its plan would phase in a $330 million increase in spending on health programs over five years.

That plan depended on higher tobacco taxes for part of its funding, initially raising the tax on a pack of cigarettes by 50 cents, to $1.29. But legislators never seriously considered the idea.

That forced them to consider less expensive alternatives. The House bill also includes provisions designed to make insurance less costly for workers who already have it and sections saying Kansans can keep their existing coverage longer when they lose or change jobs.

“It’s a good step forward,” said House Minority Leader Dennis McKinney, a Greensburg Democrat.

Legislators decided last year to provide state aid to help poor families buy insurance last year but said the aid wouldn’t start until 2009. Parents initially would be eligible if their incomes were half or less of the federal poverty level, or $8,800 for a single parent with two children.

But under last year’s law, more people eventually would have been eligible for the aid, and many Republicans became nervous this year about the costs. GOP lawmakers who liked the idea of giving families money to buy private insurance later began to see the aid as another form of welfare.

“What we are actually doing is creating a larger government,” said Rep. Jim Morrison, a Colby Republican, explaining his “no” vote on the bill.

The House bill guarantees only the first year’s worth of aid. McKinney said that gives the state a chance to see whether the program will work.

But Schmidt and other Republicans think expanding the State Children’s Health Insurance Program is a better alternative.

SCHIP current covers medical expenses of children living in households with incomes of up to twice the federal poverty level, or $35,200 for a three-person family. The Senate’s bill would raise the threshold to 2.5 times the poverty level over two years, making it $44,000 for a family of three.

But McKinney and other legislators note that President Bush has twice vetoed additional federal funding for SCHIP that would finance such an expansion.