KanCare savings result in hardship for some
11/05/2013 6:57 PM
11/05/2013 6:57 PM
Finn Bullers and I go way back. He used to be a reporter for The Kansas City Star, covering Johnson County news. He was already showing some of the early symptoms of muscular dystrophy when I met him.
Now, at age 49, Bullers finds himself fighting his advanced disease, his insurance company and Kansas officials.
Bullers has his side of the story.
His disease has left him nearly fully paralyzed on a ventilator, without which he would be dead within minutes.
If that weren’t enough of a struggle, Bullers now finds himself trying to overturn a drastic change of policy that would cut his home care each week from 24/7 around-the-clock — 168 hours — to just 40 hours.
Medicaid in Kansas has been privatized, starting this year, under the name of KanCare. The goal of this privatization, which was implemented under the leadership of Gov. Sam Brownback, is to save the state of Kansas $1 billion over five years.
Bullers would be part of those savings.
Three for-profit private insurance companies were awarded the contracts to cover the medical costs of 380,000 Kansans, who do not have the financial means to take care of themselves. About 12,000 of those have physical disabilities.
Bullers is married with two young children, 13 and 9 years old, and lives in Prairie Village. His wife works full time, 10-12 hours a day to support the family. Bullers and his family physician say he needs full-time care.
In an advertisement Bullers placed for an aide, he said he needs someone to do the following: Transfers to bed and toilet; dressing; bathing; oral hygiene; light housekeeping; meal preparation; laundry; errands/shopping.
According to Shawn Sullivan, Secretary of the Kansas Department of Aging and Disability Services, Bullers’ case has been reviewed by four individuals plus himself. He said he is “comfortable with the changes proposed.”
Sullivan said that because of privacy rules he cannot get into specifics.
Sullivan also said Bullers has multiple avenues for appeal, and during the appeal process — which could take a month or more — no changes will be made to Bullers’ care.
Bullers’ case certainly is not the only one KanCare has to resolve.
By Sullivan’s own admission, many of the 12,000 individuals with disabilities are also seeing their hours of care reduced. Obviously, the insurance companies, which operate for profit, have incentives to cut costs wherever they can. Kansas officials share the same goal.
Under the previous state-run Medicaid system, Kansas was spending far more than most other states, Sullivan said. “Before KanCare, we had a broken system,” he said.
To fix that “broken system,” KanCare, according to its own website, promises “Consumers in KanCare receive all the same services provided under the previous Medicaid delivery system, plus additional services.”
The KanCare goals, again citing from the website “are to improve overall health outcomes while slowing the rate of cost growth over time.”
Whether KanCare can truly continue to provide adequate services and slash expenses at the same time remains to be seen.
In the meantime, we hope Finn Bullers lives a long life with whatever care is reasonably required.