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Committee hears list of recent legislative additions and revised KanCare caseloads
Summary
KLRD and KDHE staff reviewed legislative rate increases, nursing facility rebases, CCBHC conversion funding and updated caseload estimates that together raise Medicaid spending pressures.
Megan Leopold of the Kansas Legislative Research Department reviewed a multi-year list of legislative additions to Medicaid funding the committee had received in its packet and explained how those additions contributed to recent expenditure growth.
Leopold detailed additions by legislative session: examples cited included provider rate increases and rebases for nursing facilities, funding to convert community mental health centers to certified community behavioral health clinics (CCBHCs), and increases in provider assessment authority. She told the committee that large additions included nursing facility rebases and a community mental health center conversion in recent years. The committee packet included a table of specific additions back to 2019.
Leopold also gave the committee KLRD’s revised caseload estimates used for budget planning. For fiscal 2025 the revised estimate for KanCare medical was about $5.0 billion all funds and $1.3 billion in state general fund, a modest decrease from prior estimates largely because population increases were lower than anticipated. For fiscal 2026 the revised KanCare medical estimate was about $5.3 billion all funds and $1.5 billion SGF. She said some decreases in SGF were driven by higher HMO privilege-fee revenue that offsets SGF expenditures.
Leopold highlighted several line items that contributed to year-over-year SGF increases: nursing facility daily rate rebases, provider reimbursement increases for items such as physician and outpatient hospital provider codes, and additions that funded moving people from IDD waiver wait lists into services. She pointed the committee to a detailed, regularly updated medical assistance report that breaks out eligibility categories and capitation payments by code.
Committee members asked for additional detail, including exact historical state general fund dollar amounts behind the expenditure charts and whether caseload changes reflect changes in population mix rather than only total enrollment.
Ending: Leopold said she would provide the chart-level tables and clarified that the caseload estimates discussed were those made in April and not yet incorporated into any later appropriation changes.
