We did it! Kansas’ Health Insurance Application withdrawn!


Recently one blogger pointed out how managed care systems might be a violation of human rights. I’ve also been recently posting about how the addition of managed care into our public system in 31 states currently is ripe for mental health reform. If we advocate effectively, we can ask for every change we’ve ever wanted for medication optimization. This can all be added into these companies’ contracts.

Here’s my first post:
Did you speak up yet? Do you want reform? You can still make comments.

Charlotte Morrison sports a Please Cut our Budgets shirt at the Kansas Medicaid Reform Forum
Charlotte Morrison sports a Please Cut our Budgets shirt at the Kansas Medicaid Reform Forum

I just wanted to make a brief post about our victory in in Kansas, to encourage people and to let you know about similar situations that might be going on in your state. In Kansas, we had a nonprofit, Kansas Health Solutions, that worked like a managed care organization for several years to look at access to mental health care.

This organization was a little problematic because the board of directors of Kansas Health Solutions was made up of the executives from some of Kansas’ 29 licensed community mental health centers. So this group decided how to spend money on mental health care that was being spent at their own organizations. You might have a similar problem in your state. It was real situation of the fox guarding the chicken coop. Kansas’ peer advocates grumbled about this situation a little, not too loudly, because their statewide organization was focused on other things. Then budget cutting politicians started in.

Then the director of Kansas Health Solutions got caught embezzeling $1.2 million dollars, so the state rushed through fairly quickly an application to covert all their Medicaid spending to private insurance companies. But it turned out that the state missed a whole lot of details. On our Medicaid conversion input forum, we had over 70 comments, more than any other state. (Check your state now – there are still a whole lot of states with zero comments.)

They mostly said things like:

    • This process is going way too fast.
    • I don’t want the state budget to be balanced on the backs of people with disabilities
    • Managed care doesn’t work very well in the states that already have it
    • Use social entrepreneurship, not pure capitalism.
    • We already know good ways to help people that would save tons of money. This is my blog post on Please Cut our Budgets – We’ll Tell you How.¬†And a link where you can get your very own Cut Our Budgets T-shirts.


Then the Kansas Mental Health Coalition finally weighed in. This is the group of hospital and mental health center advocates that I’ve renamed the “Mental Health Provider Coalition.” I’m sure you have something similar in your state. They have one peer member and 30 professional members typically at each meeting and say they have very effective peer input. The good thing is that the one person in recovery has almost just read Whitaker’s book and that they might invite me to come speak to them. But I couldn’t stand their meetings any more myself.

I’m just tired of an approach to mental health care that involved sticking my hand out to governments and saying, “Please??” As in, “Please let us keep doing things the same exact way.” But for once the Kansas Mental Health “Provider” Coalition ¬†(and you know your state has one too) had a good analysis of the situation.

We are already functioning in a managed care environment for behavioral health, including addictions treatment. We are concerned that there will be insufficient transition mechanisms for consumers who are already receiving services through specific provider networks. The current managed care system (PAHP) allows savings to be re-invested back into service delivery. For mental health treatment this is critical due to disproportionate level of reductions in services which have been made over the last several years. The proposed managed care system will not provide for that reinvestment.

Or in English: “We don’t want some corporation trying to make a profit by denying care. Right now any savings made by denying health care is reinvested to provide some other kind of care.”

And so finally the government realized they had missed a step, and Kansas politicians came¬†¬†finally made with this statement that: “We have concluded that further consultation regarding KanCare is appropriate. At the same time, we will also provide for broader public comment consistent with the transparency process established in the CMS regulations that became effective April 27, 2012. Therefore, we ask that you not consider our April 26, 2012, submission to be a formal proposal; we will send you a formal proposal once our consultation and public comment processes are complete….”

David Flora with the Please Cut Our Budget T-shirt at the Kansas Medicaid Reform forum
David Flora with the Please Cut Our Budget T-shirt at the Kansas Medicaid Reform forum

So Victory!

And the moral of this story:
1) Advocacy requires a bit of work to find this kind of stuff out. What do you know about your state situation?
2) The change isn’t going to come from the status quo people. It needs us to be both inside the room talking and outside the room yelling with signs.
3) Public input does work. What can you tell CMS today about your state? Click NOW and DO IT: http://cmsideas.uservoice.com/forums/141980-medicaid-gov



Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion‚ÄĒbroadly speaking‚ÄĒof psychiatry and its treatments. The opinions expressed are the writers’ own.


Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.


  1. I am that blogger on human rights and managed care. What an accomplishment for you all to protect human rights from managed care that would put profits first. Your illustration also indicates how even not-for-profit managed care systems can have major conflicts of interest.

    You should be – and are – a model model in Kansas. More, please

    Report comment