health care

TOPEKA, Kansas — The 2020 federal marketplace for individual health insurance includes more options than ever for Kansas, and premiums for some of those plans are less expensive than 2019. But for the second year in a row, all of the plans will leave consumers footing the full bill for most out-of-network care.

The silver lining: Two new insurance companies have jumped into Kansas this year, offering health plans in some of the state’s most populous counties. A third insurer that’s already active in Kansas City and its suburbs is expanding to 12 more southeast and central Kansas counties.

A private insurer’s 2018 premiums in Kansas ran too high — at least compared to the medical bills it had to pay for customers that year.

That means thousands of Kansans get money back this fall because they got overcharged last year.

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On the last Tuesday of July, Tres Biggs stepped into the courthouse in Coffeyville, Kansas, for medical debt collection day, a monthly ritual in this quiet city of 9,000, just over the Oklahoma border. He was one of 90 people who had been summoned, sued by the local hospital, or doctors, or an ambulance service over unpaid bills. Some wore eye patches and bandages; others limped to their seats by the wood-paneled walls. Biggs, who is 41, had to take a day off from work to be there. He knew from experience that if he didn’t show up, he could be put in jail.

SALINA, Kansas — The University of Kansas School of Medicine-Salina opened in 2011 — a one-building campus in the heart of wheat country dedicated to producing the rural doctors the country needs.

Now, eight years later, the school’s first graduates are settling into their chosen practices — and locales. And those choices are cause for both hope and despair.

Aetna Better Health is struggling to keep its Medicaid contract with KanCare, to the point that state officials found fault with Aetna’s recent plan to improve services.

But Kansas lawmakers had two words this week for the company: Keep trying.

Stephanneth Adams plans to leave Kansas.

The nurse practitioner landed in the state’s rural southwest — where she saw patients in Garden City, Dodge City and Liberal — through a federal program aimed at stubborn health care shortages in urban and rural America.

But why stay? Adams has her eyes on Nevada, a state that lets its most educated nurses roll up their sleeves and work without permanently needing, as they do in Kansas, permission from a physician.

Supporters of expanding Medicaid in Kansas proved Wednesday they’ve got the votes in the Legislature — if they can get a vote.

But they lacked enough lawmakers on their side to bypass Republican leadership and force that vote.

The word audacious has a double meaning.

Depending on whom you talk to, either definition might apply to the way the Kansas Farm Bureau is proposing to rescue farmers and ranchers priced out of the health insurance marketplace set up under the federal Affordable Care Act.

It’s either a bold and daring move. Or, it’s presumptuous, bordering on brazen.

The powerful ag lobbying organization is petitioning lawmakers for what amounts to carte blanche authority to develop and market health coverage free of state and federal oversight.

Kris Kobach says his proposal to reform Kansas Medicaid could save the state $2 billion.

At campaign events, the Republican nominee for governor touts the benefits of combining Medicaid with direct primary care, an unconventional payment system that avoids the bureaucracy of health insurance.