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A Look At How The Graham-Cassidy Bill Would Affect Kansas

MICHEL MARTIN, HOST:

We'd like to take our health care discussion to Kansas now to speak with Lieutenant Governor Jeff Colyer. the lieutenant governor is in line to succeed Governor Sam Brownback, who's expected to be confirmed as an ambassador in the coming weeks. And Mr. Colyer is also a physician. So Lieutenant Governor Dr. Colyer is with us on the line now to talk about how his administration might handle this important issue. Lieutenant Governor, thank you so much for speaking with us.

JEFF COLYER: You know, it's a beautiful day today in Kansas.

MARTIN: All right. Well, we're glad about that. So Governor Brownback was a vocal opponent of the Affordable Care Act or the ACA. And earlier this year, he vetoed a bill to expand Medicaid in Kansas. You've voiced your opposition to the ACA in the past, but Kansas' two senators were split on the last Republican bill which would have repealed it. Senator Pat Roberts supported it, Senator Jerry Moran did not. Tell me where you are on Graham-Cassidy. What's your take on that?

COLYER: Graham-Cassidy is a good opportunity for us to start dealing with the failings of what's going on right now. Graham-Cassidy has opportunity for states to control their own health care system. And we in Kansas, we had one of the most innovative health plans before Obamacare came in. When states can control their health care, they can innovate. They can work very closely with companies and individuals of the state to get the best solutions.

MARTIN: So you took the lead in running KanCare, which is Kansas's effort to privatized Medicaid. There were problems with that at first. Can you talk a little bit about that? And do you believe that you've fix those problems? I mean, I think you're well acquainted with the criticisms - very long wait times for non-essential care, things of that sort. Talk about that, if you would.

COLYER: Well, what we had under the previous system is we had basically a single-payer. And in Kansas, there were decisions made such as Kansas would not pay for heart transplant, and now of days, we actually will. We gave everybody three choices. We bid out our insurance plans so that every Kansan that's in the Medicaid program can choose between plans.

What we've seen is that, actually, the number of doctors visits has gone up. ER visits have gone down. And the number of hospital days has gone down. And we're seeing an improvement in results in health care. And while we're doing that, we're able to save money. And how we were able to save money is not doing as expensive care but getting the right care at the right place.

MARTIN: It's my understanding that part of the problem with KanCare is that people are still in a coverage gap, that they make too much to qualify for KanCare but they don't make enough to qualify for federal subsidies to purchase private insurance. And they certainly don't make enough money to pay for private insurance without a subsidy. Is that still the issue?

COLYER: We actually have a system where we're trying to address those gaps, but those gaps are because of a lot of issues that are out there. We're not like Massachusetts. We're not like California. We have, for example, a high rural population. And how do we help those rural hospitals? How do we help get more doctors into Garden City, Kan.? Well, to do that, it's not because of what the Medicaid program looks at. It is, how do we use those dollars to best come up with a Kansas solution?

MARTIN: So before we let you go, Lieutenant Governor, if the current Republican alternative does not go forward - as we are speaking now, that's very much up in the air - what would you like to see happen next?

COLYER: What is important is that we start working for some solutions. And we need to work together, and that doesn't mean one way or the other. But for us, what has happened, you know, we've worked on a lot of solutions in Medicaid. We started out - we had hundreds of people show up to meetings across the state about, how do we start fixing Medicaid? And we've done that, and we've repeatedly done those. And those conversations are really helpful because ordinary Kansans know what's going on and they want solutions. And it's not a political issue, you know. Let's get it done.

MARTIN: That is Lieutenant Governor Jeff Colyer. He's the lieutenant governor of Kansas as well as Dr. Colyer, a physician. And he was kind enough to talk to us from Overland Park, Kan. Lieutenant Governor Dr. Colyer, thank you so much for speaking with us today.

COLYER: Great. It's good to visit with you. And I look forward to having more conversations.

(SOUNDBITE OF LUNA'S "23 MINUTES IN BRUSSELS") Transcript provided by NPR, Copyright NPR.