Division of the Budget
Landon State Office Building Phone: (785) 296-2436
900 SW Jackson Street, Room 504 adam.c.proffitt@ks.gov
Topeka, KS 66612 Division of the Budget http://budget.kansas.gov
Adam Proffitt, Director Laura Kelly, Governor


February 22, 2023


The Honorable William Sutton, Chairperson
House Committee on Insurance
300 SW 10th Avenue, Room 218-N
Topeka, Kansas 66612
Dear Representative Sutton:
SUBJECT: Fiscal Note for HB 2287 by House Committee on Health and Human
Services
In accordance with KSA 75-3715a, the following fiscal note concerning HB 2287 is
respectfully submitted to your committee.
HB 2287 would prohibit imposing cost-sharing requirements for diagnostic and
supplemental breast examinations for any individual or group health insurance policy (or similar
contract or plan) that provides coverage for accident and health services that is delivered, issued
for delivery, amended, or renewed on or after January 1, 2024.
The Department of Administration estimates enactment of HB 2287 would increase costs
to the State Employee Health Plan by $1.2 million from special revenue funds in FY 2024. The
estimate assumes a first-year cost increase of $2.3 million; however, because the bill’s provisions
would not go into effect until January 1, 2024, only half the annual cost would apply to FY 2024.
The Department of Administration notes for employees enrolled in an Internal Revenue
Service (IRS) qualified high deductible health plan (QHDHP) and contributing to a health savings
account (HSA), the IRS has identified those services which may be paid by a health plan before
the QHDHP deductible has been satisfied. Screening mammography is identified in the Preventive
Care Screening Safe Harbor as a service that can be paid before the QHDHP deductible is satisfied.
Screening mammography is an Affordable Care Act preventive care service paid at 100.0 percent
by the health plan for all State Employee Health Program (SEHP) members. The additional
services being proposed in this bill are not included as eligible under the IRS safe harbor guidance.
If they are not eligible and the health insurance plan is required to cover them at 100.0 percent like
screening mammography, it likely disqualifies employees and the state from contributing to an
HSA. This could affect approximately 50.0 percent of the SEHP enrollment who have an HSA
The Honorable William Sutton, Chairperson
Page 2—HB 2287

today. Without the HSA, members would likely change their plan enrollment to Plans A or J,
which have a richer benefit, but no HSA. This enrollment shift likely would have a direct fiscal
effect on the SEHP’s finances and rates; however, a fiscal effect cannot be estimated. In addition,
any Kansan enrolled today on an insured QHDHP with an HSA would likely face this same issue.
The Kansas Insurance Department indicates the bill’s enactment would constitute a new
mandate for purposes of state cost defrayal under the Affordable Care Act and the Department
states it is unable to estimate a fiscal effect. Any fiscal effect associated with HB 2287 is not
reflected in The FY 2024 Governor’s Budget Report.


Sincerely,

Adam Proffitt
Director of the Budget

cc: Bobbi Mariani, Insurance Department
Tamara Emery, Department of Administration


Statutes affected:
As introduced: 40-2, 40-19c09, 40-2407, 40-2411