SESSION OF 1998



SUPPLEMENTAL NOTE ON HOUSE SUBSTITUTE FOR

SENATE SUBSTITUTE FOR SENATE BILL NO. 424



As Amended by House on Final Action





Brief(1)



House Sub. for Senate Sub. for S.B. 424 creates a new act that authorizes a new health insurance program for targeted children that is to be developed and implemented pursuant to guidelines set out in the bill and Title XXI of the Social Security Act. The bill establishes a children's health care program fund and a Kansas insurance coverage for children fund; creates a joint committee on children's issues; and sets out duties of the Secretary of Social and Rehabilitation Services. Targeted children for the purposes of Title XXI are those in families with an income at or below 200 percent of the federal poverty guidelines.



House Sub. for Senate Sub. for S.B. 424, in Section 1, directs the Secretary of Social and Rehabilitation Services to develop a children's health insurance plan that is consistent with guidelines set out in federal law and that meets the criteria set out in subsections (b) through (f) of Section 1. The plan is to be submitted to the Health Care Financing Administration as required by federal law. Pursuant to the provisions of subsection (c), the Secretary is authorized to enter into all-inclusive contracts with entities authorized to do business as health insurers in Kansas to implement the health insurance plan directed by the bill or to contract for specialized services such as mental health managed care, subject to the restrictions set out in the bill. The Secretary is directed to adopt rules and regulations necessary to implement the insurance plan developed under Section 1.



Section 3 of House Sub. for Senate Sub. for S.B. 424 prohibits the expenditure of any funds appropriated to implement the health insurance for children authorized by the bill for any abortion, except as authorized by the bill.



Section 4 directs the Secretary of Social and Rehabilitation Services to include children eligible for coverage under the Kansas Medicaid program in contracting with entities to provide capitated managed care for targeted children under the new authority of the bill.



Section 5 directs the Secretary to contract with private entities for administrative services arising from implementation of a child health insurance plan. The following section directs the Secretary to cooperate with the Health Care Data Governing Board.



Section 8 of the bill creates a 10-member joint legislative committee on children's issues; provides for the appointment of members for two-year terms; provides for the appointment of the committee chair; authorizes the committee to meet at any time and place on call of the chair; and directs the joint committee to oversee the implementation and operation of the child health insurance plan authorized by Sub. for S.B. 424. At least one committee member from the House is to be a member of the House Committee on Health and Human Services, one member a member of the House Committee on Insurance, and one member a member of the House Committee on Appropriations. Of the Senate appointees, at least one is to be a member of the Senate Committee on Public Health and Welfare, one a member of the Senate Committee on Ways and Means, and one a member of the Senate Committee on Financial Institutions and Insurance. Section 7 directs the Secretary to report to the joint committee and to make recommendations on possible additions to the child health insurance plan developed pursuant to the bill and on performance measures applicable to the plan.



Section 9 establishes the children's health care programs fund; provides for crediting 50 percent of any funds received from any tobacco litigation settlement or judgement to the fund; and sets out the purposes for which monies deposited in the fund may be used. Section 10 establishes the Kansas insurance coverage for children fund, provides for deposit of any grants, gifts, or donations to the fund; requires the transfer from the State General Fund of interest earned by the fund; and requires expenditures from the fund to be made in accordance with appropriation acts for the child health insurance program.





Background



S.B. 424 was developed and introduced by the Health Care Reform Legislative Oversight Committee following study of Kansas' implementation of a children's health insurance program directed toward targeted low-income children who do not have health insurance and who are not eligible for Medicaid. The study arose in response to passage of the federal Balanced Budget Act of 1997, a section of which added a new Title XXI to the Social Security Act under which federal grants are authorized to be made to the states for federal cost-sharing in implementing a children's health insurance program for targeted children. In order to qualify for federal funding, a state must submit a plan to the Health Care Financing Administration for review. Two task forces, one created by the Insurance Commissioner and one appointed by the Secretary of Social and Rehabilitation Services, met over the late summer and fall and brought joint recommendations to the Health Care Reform Legislative Oversight Committee in December. S.B. 424 was introduced to provide authorizing legislation and guidelines for Kansas' implementation of Title XXI.



Subsequent to the introduction of S.B. 424, the President of the Senate and the Speaker of the House of Representatives appointed a task force composed of members of each house and the Executive Branch to consider S.B. 424 and issues relating to a Kansas child health insurance program. The legislative task force recommendations differ from those made by the earlier task force groups, primarily in terms of cutting a proposed expansion of Medicaid from the Kansas plan for a child health insurance program. The task force also recommended more detailed guidelines for implementation than were in S.B. 424, as introduced. House Sub. for Senate Sub. for S.B. 424 embodies the work product of the legislative task force, a Senate Committee, and a subcommittee of the House Committee on Appropriations.



For a summary of the provisions of Title XXI, a copy of the federal legislation, a table showing federal fund allocation to the states for FFY 1998, and other information, see the Report of the Health Care Reform Legislative Oversight Committee to the 1998 Legislature and the appendices therein.



The Governor's Budget Report includes $42.7 million, of which $12.0 million is State General Fund, to finance a health insurance program for children that meets the requirements of federal law.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/fulltext-bill.html.