KDHE Secretary Janet Stanek affirms the safety of COVID-19 vaccinations to lawmakers questioning Kansas health response to the COVID-19 pandemic during a Jan.11, 2023 committee meeting. (Rachel Mipro/Kansas Reflector)
TOPEKA — With federal “continuous coverage” Medicaid protections ending, thousands of Kansans are expected to be dropped from medical programs in the coming months.
While President Joe Biden is expected to extend the public health emergency issued for COVID-19, one that allowed for health-related measures and the continuous coverage policy, states will no longer have to keep providing Medicaid coverage. That’s because of a Congress-approved December 2022 spending package Biden signed. The package allows states to begin redetermining eligibility for Medicaid in April for the first time in three years.
State Medicaid Director Sarah Fertig said the process would be lengthy, estimating that 525,000 Kansans are currently enrolled in Medicaid, with about 115,000 more users than normal.
This increase in users has been attributed to the pandemic-era federal protections, which stipulated that KanCare couldn’t end Medicaid eligibility unless the person in question moves away, dies or asks to end coverage.
“We anticipate quite a few will be removed,” Fertig said in a Wednesday overview of the situation to the Senate Public Health and Welfare Committee.
There’s been a push for Medicaid expansion by lawmakers, including Gov. Laura Kelly, with the issue expected to come up during the legislative session. Thirty-eight states have implemented Medicaid expansion or passed expansion measures, including Missouri, Colorado and Nebraska.
“We’ve been putting off doing eligibility redeterminations for large chunks of our population for almost three years now; we’re going to resume them,” Fertig said. “And what that means is we have some folks on the Medicaid rolls now who, once we try and renew them for eligibility, they’re not going to be eligible anymore. And they’re going to be falling off the rolls.”
Her department is finalizing plans for determining Medicaid eligibility, in an attempt to make the transition smoother. Those plans will be submitted for review in February.
Other 2023 priorities for Kansas Medicaid include improving maternal health and shifting authority for Medicaid away from the federal government. Fertig said they were working on strengthening state Medicaid authority to create more freedom with health care programs and state investments in health.
Fertig said she and other health officials would also focus on prenatal care and better health outcomes for Kansas mothers. Due to recent policy changes, Medicaid coverage was extended for postpartum women, going from two months of coverage after birth to 12 months of postpartum coverage.
“Now that we have the policy change, we’ve been researching ways to make more of a dent in maternal mortality and morbidity in Kansas,” she said.
Some of the possibilities explored include earlier access to medical care during pregnancy, as well as having doulas assist in births.
During the committee meeting, lawmakers also questioned health officials on the efficacy of the COVID-19 vaccine.
Republican Sen. Mark Steffen, who has introduced legislation that would loosen COVID-19 vaccination requirements, asked Kansas Department of Health and Environment Secretary Janet Stanek if she and other health officials had learned anything from the Centers of Disease Control and Prevention.
Steffen mentioned the updated Kansas pandemic and infectious disease plan, which outlines the state’s preparations for future infectious outbreaks. He said parts of the plan, such as addressing misinformation and working with the news media, as well as vaccine evaluations, were fringe issues that violated First Amendment rights.
“My question is, where you all basically followed the CDC down the pathway of confusion and chaos through that COVID response, did we learn anything from that, and is it reflected within that extensively long document?” Steffen said.
Stanek said she stood by the plan, and that a lot of effort and care went into its production.
Republican Sen. Mike Thompson said he believed COVID-19 vaccines were “extremely dangerous,” and didn’t think the vaccinations should be required for medical transplant patients.
“During the pandemic, the CDC kind of set the standards and now all of a sudden that information has been released showing that well, they weren’t quite as up to speed on the efficacy and the dangers of vaccines,” Thompson said.
Steffen then asked Stanek if the KDHE still considered the COVID-19 vaccine to be safe and effective, saying there have been cases of myocarditis related to the COVID-19 vaccine. Stanek confirmed COVID-19 vaccine safety.
“We know that there are always categories of people in any case with a vaccine that could have an adverse reaction,” Stanek said. “I’m not here to expound upon medical expertise, but based on what our guidance is with CDC and recommendations related to the medical community.”
Steffen and Thompson have introduced legislation that would require exempt places like child care facilities, elementary schools, high schools and postsecondary educational institutions from vaccine requirements, without inquiry into why the exemption request was asked for.
The legislation would also get rid of the requirement to have a meningitis vaccine requirement in order to live in student housing, according to the bill summary.
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