The Kansas House passed a health care package Tuesday that will give many Kansans greater insurance flexibility, extend coverage to some of the state's poorer residents, increase funding for cancer prevention by covering the cost of more screenings in rural health centers, and make added prenatal care available for poor women.  One significant addition was an expansion of the Premium Assistance program enacted last year. 

The House bill was a gentler, kinder, much more expensive version of a bill the Kansas Senate had passed last week. The Senate bill got a complete, and almost instant, makeover in the House, where the floor debate lasted less than three hours. That was time enough, however, for the bill’s contents to be changed dramatically and when the vote was taken, the measure passed by a 103-20 margin. The only side-effect? The $10 million price tag - and there's no money in the budget for it.

David Klepper's piece in the Kansas City Star contains some of the details.

When the bill came to the House from the Senate and was postponed last Friday, Republican and Democrat House leaders began searching for a behind-the-scenes compromise.  Rep. Jeff Colyer, R-Overland Park, made wholesale changes in the bill and that attracted a swarm of bi-partisan votes - and some praise from lobbyists. 

“We make compromises, we make hard choices, we have some difficult choices ahead of us," said Colyer in explaining the negotiated package, "and we’re going to have to keep up with health reform over the next few years."

According to the Kansas Health Institute, Marcia Nielsen, director of the Legislature-created Kansas Health Policy Authority, said, “We have a fair compromise.  The bill does represent a big first step and we’re very pleased.” 

About last week’s Senate bill (reported by Kansas Liberty  here), Nielsen told KHI, “Basically, we expanded SCHIP (state program for low-income children), defined ‘medical home’ and added the commissioner of education to the KHPA board — that’s it.”

The House stripped out key parts of the original bill, including proposed penalties for Medicaid recipients who failed to adopt healthy lifestyle changes. The program, contingent on the Legislature’s approval of the expenditure, will start next January to subsidize private health insurance policies for low-income families.  The bill, Sub. SB 81, will also extend eligibility to childless adults, but would cap the program’s first-year cost at $4 million.  Other details of the floor amendments are summarized by the Kansas Legislative Research Department.

Among those critical of the deal-making process was Rep. Mike O’Neal, R-Hutchinson.  “There are more people interested in this subject than just the people in this Capitol. They have a right to have health care policy decided in the open, not behind closed doors,” he said.  

However, House Minority Leader Rep. Dennis McKinney, D-Greensburg, pointed to the interim studies and committee hearings. “This was by no means a process devoid of public input,” he said.

Disparaging the core substance of the House bill was Rep. Jim Morrison, R-Colby. “We’re creating a lot larger government, higher costs of health administration and I believe less, not greater, numbers of people who will be on insurance,”  Morrison said, adding, “The system is not competitive and that’s the problem.  We don’t have the guts to go ahead and, in any way, approach it.”

• Read the bill: Sub. SB 81.