SESSION OF 2019
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2066
As Amended by House Committee of the Whole

Brief*
HB 2066, as amended, would establish the KanCare
Bridge to a Healthy Kansas Program (Program). The Kansas
Department of Health and Environment (KDHE) would be
required to administer and promote the Program and provide
information to potential eligible individuals who live in
medically underserved areas of the state. The bill would
modify the eligibility requirements for the Kansas Medical
Assistance Program, on or after January 1, 2020, to include
any non-pregnant adult under 65 years of age, whose income
does not exceed 133 percent of the federal poverty level
(FPL), to the extent allowed under the federal Social Security
Act as it exists on the effective date of the bill, and subject to
the requirements of the Program. The bill would require
referral to workforce training programs; create a Program
Drug Rebate Fund and a Program Privilege Fee Fund; create
a health insurance coverage premium assistance program;
address federal denial and approval of financial participation;
require submission of a state plan amendment, waiver
request, or other approval request necessary to the federal
government; prohibit coverage or reimbursement for any
abortion services under the Program; require enrollees to pay
a monthly fee for participation in the Program; require various
Program reports to the Legislature; and create a Program
Working Group.
The bill would state the Legislature expressly consents
to expand eligibility for receipt of benefits under the Kansas
Program of Medical Assistance by the passage and
enactment of the Program.
____________________
*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.kslegislature.org
KanCare Bridge to a Healthy Kansas Program
Workforce Training Program Referral
The bill would require KDHE to refer certain non-
disabled adults to the state’s existing workforce training
programs and work search resources, as outlined in the bill.
The bill would provide exemptions from the referral for:
● Full-time students for each year they are enrolled
in a postsecondary education institution or
technical school; and
● Parents with minor children in the home, at the
discretion of KDHE.
Program Application
The bill would require the Program application to screen
applicants for education status and employment status, and
require applicants to acknowledge KDHE referrals to
workforce training programs and work search resources.
Health Insurance Coverage Premium Assistance Program
The bill would allow KDHE to establish a health
insurance coverage premium assistance program for
individuals with an annual household income of not more than
133.0 percent of the FPL or for individuals eligible for health
insurance coverage through an employer but who cannot
afford the premiums.
The bill would require a premium assistance program to
contain eligibility requirements the same as those for the
Program and provide that an individual’s payment for a health
insurance coverage premium cannot exceed 2.0 percent of
the individual’s annual income.

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Monthly Fee
KDHE would be required to charge each person enrolled
under the Program a $25 monthly fee as a condition of
participation in the Program, up to a maximum of $100 per
month per family household. KDHE would be required to
remit all monthly fees collected to the State Treasurer. The bill
would require the State Treasurer to deposit the entire
amount into the State Treasury to the credit of the State
General Fund (SGF).
The bill would require KDHE to suspend an enrollee’s
coverage under the Program for three calendar months
following three consecutive calendar months of nonpayment
of the fee established under this section. Any such
suspended enrollee would be allowed to apply for
reinstatement of coverage one time. KDHE would be required
to suspend an enrollee’s reinstated coverage permanently
following another three consecutive months of nonpayment of
the monthly fee.
Federal Denial of Approval and Financial Participation
If a denial of federal approval and federal financial
participation that applies to any part of the Program would
occur, KDHE would not be prohibited from implementing any
other part of the program that is federally approved for federal
financial participation or does not require federal approval or
federal financial participation—except, if at any point the
federal match for non-pregnant adults under 65 years of age
and with income not exceeding 133.0 percent of the FPL is
less than the enhanced federal match rate under the federal
Health Care and Education Reconciliation Act of 2010, as it
exists on the effective date of this bill, KDHE would be
required to terminate the Program over a 12-month period,
beginning on the first day the federal medical assistance
percentage falls below such amount.


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 KDHE would be allowed to make changes to the
Program if required by the U.S. Department of Health and
Human Services (HHS) or federal statute or regulation.
Implementation Approval Request
KDHE would be required to submit to the Centers for
Medicare and Medicaid Services a plan amendment, waiver
request, or other approval request necessary to implement
the Program.
Program Drug Rebate Fund
The bill would create the KanCare Bridge to a Healthy
Kansas Program Drug Rebate Fund (Rebate Fund) as a
reappropriating fund. The bill would require all moneys
collected or received by the Secretary of Health and
Environment from drug rebates connected to Program
beneficiaries to be deposited in the Rebate Fund and such
funds to be expended for the purpose of Medicaid medical
assistance payments for Program beneficiaries. The bill
would require the Rebate Fund to be used only for the
Program and would state it is the intent of the Legislature the
Rebate Fund remain intact and inviolate and not be subject to
transfers and allotments. The bill would provide for the
monthly transfer of interest earnings, as outlined in the bill,
from the SGF to the Rebate Fund.
Rebate Fund Report to Legislature
On or before January 11, 2021, and on or before the first
day of the regular legislative session each year thereafter, the
Secretary of Health and Environment would be required to
prepare and deliver a report to the Legislature summarizing
all expenditures from the Rebate Fund, Rebate Fund
revenues, and recommendations regarding the adequacy of
the Rebate Fund to support necessary Program
expenditures.

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Program Privilege Fee Fund
The bill would create the KanCare Bridge to a Healthy
Kansas Program Privilege Fee Fund (Privilege Fee Fund) as
a reappropriating fund. The bill would require all moneys
collected or received by the Secretary of Health and
Environment from privilege fees connected to Program
beneficiaries to be deposited in the Privilege Fee Fund and
such funds to be expended for the purpose of Medicaid
medical assistance payments for Program beneficiaries. The
bill would state legislative intent that the Privilege Fee Fund
remain intact and inviolate and not be subject to transfers and
allotments. The bill would provide for the monthly transfer of
interest earnings, as outlined in the bill, from the SGF to the
Privilege Fee Fund.
Privilege Fee Fund Report to Legislature
On or before January 11, 2021, and on or before the first
day of the regular legislative session each year thereafter, the
Secretary of Health and Environment would be required to
prepare and deliver a report to the Legislature summarizing
all expenditures from the Privilege Fee Fund, Privilege Fee
Fund revenues, and recommendations regarding the
adequacy of the Privilege Fee Fund to support necessary
Program expenditures.
Program Cost Savings Report to the Legislature
On or before January 11, 2021, and on or before the first
day of the regular legislative session each year thereafter, the
Secretary of Health and Environment would be required to
prepare and deliver a report to the Legislature summarizing
the cost savings achieved by the State from the movement of
beneficiaries from the KanCare program to the Program,
including, but not limited to, the MediKan program, the
medically needy spend-down program, and the breast and
cervical cancer program. The bill would specify the method
for calculating the cost savings.
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Inmate Inpatient Hospitalization Cost Savings Report to the
Legislature
On or before January 11, 2021, and on or before the first
day of the regular legislative session each year thereafter, the
Secretary of Corrections would be required to prepare and
deliver a report to the Legislature identifying the cost savings
achieved by the State from the use of the Program to cover
inmate inpatient hospitalization.
KDHE Annual Report to Legislative Committees
On or before February 15 of each year, the Secretary of
Health and Environment would be required to present a
report to the House Committee on Appropriations and the
Senate Committee on Ways and Means summarizing the
costs for the Program and the cost savings and additional
revenues identified in previously mentioned annual reports to
the Legislature on the Drug Rebate Fund and the Privilege
Fee Fund and the report on Program cost savings.
Program Working Group
The bill would establish the KanCare Bridge to a Healthy
Kansas Working Group (Program Working Group) that would
be charged with identifying non-SGF sources to fund any
Program shortfall identified by the Secretary of Health and
Environment in the annual report to the legislative
committees.
The Program Working Group would have the following
membership:
● Two House members appointed by the Speaker of
the House of Representatives;
● One House member appointed by the Minority
Leader of the House of Representatives;

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 ● Two Senate members appointed by the President
of the Senate;
● One Senate member appointed by the Minority
Leader of the Senate;
● One representative from each of the following:
○ Kansas Hospital Association;
○ Kansas Medical Society;
○ Community Care Network of Kansas;
○ Kansas Academy of Family Physicians;
○ Association of Community Mental Health
Centers of Kansas;
○ Kansas Dental Association;
○ Kansas Emergency Medical Services
Association;
○ Kansas Optometric Association; and
○ Kansas Pharmacists Association; and
● One representative of Program consumers from
Alliance for a Healthy Kansas.
The members of the Program Working Group would
elect the chairperson from members of the Program Working
Group who are members of the House of Representatives in
even-numbered years and from members of the Program
Working Group who are members of the Senate in odd-
numbered years.
The bill would require legislative to provide assistance
as requested by the Program Working Group.
Legislative members of the Program Working Group
would receive compensation and travel expenses and
subsistence expenses or allowances, as provided by KSA 75-
3212, for attending a meeting of the Program Working Group
or a subcommittee meeting thereof. Non-legislative members
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would not receive compensation, subsistence allowance,
mileage, or associated expenses from the State for attending
a meeting or subcommittee meeting of the Program Working
Group.
The Program Working Group would be required to meet
no fewer than two times in a calendar year. Nine members
would constitute a quorum, of which the bill would require at
least four to be legislative members of the Program Working
Group. Additionally, on or before March 15 of each year, the
Program Working Group would be required to report to the
Legislature recommendations for funding the Program, as
necessary.
Restriction on Abortion Coverage
The bill would prohibit the Program from providing
coverage or reimbursement for abortion services.
The bill would be in effect July 1, 2020, and upon
publication in the Kansas Register.

Background
HB 2066, as introduced, would have amended the
Kansas Nurse Practice Act to establish advance practice
registered nurse (APRN) requirements for certification and
address other matters related to APRN practice. [Note: The
bill, as amended by the House Committee of the Whole, does
not contain the APRN provisions.]
On March 20, 2019, the House Committee of the Whole
amended the bill by removing the contents of the bill, as
amended by the House Committee on Health and Human
Services, and inserting new language establishing the
Program. The House Committee of the Whole then amended
the Program language to require enrollees be charged a
monthly premium as a condition of participation in the
program with the moneys collected deposited in the State
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Treasury to the credit of the SGF; provide for the suspension
and termination of an enrollee’s coverage for non-payment of
the premium charge under certain conditions and allow for a
one-time reinstatement; and prohibit coverage or
reimbursement for any abortion services under the Program.
The House Committee of the Whole recommended the bill, as
amended, favorably for passage.
No fiscal note was available on the amended language
at the time the House Committee of the Whole considered the
bill.


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Statutes affected:
As introduced: 65-1113, 65-1130, 65-4101
As Amended by House Committee: 65-1113, 65-1130, 65-4101, 40-3401
{As Amended by House Committee of the Whole}: 65-1113, 65-1130, 65-4101, 40-3401, 40-3213