From Think Progress, October 27, 2014
by Carl Gibson
The conservative experiment in Gov. Sam Brownback’s Kansas has led to more suffering across the board — not just for the state’s economy, but for people with disabilities who are losing life-sustaining services.
At the time of his inauguration, Brownback was touted by fellow Republicans as a model example of what conservative governance nationwide could look like. While he promised to rejuvenate the state’s economy by slashing the state’s top income tax rate by 26 percent, his fiscal policy has instead blown an $800 million hole in the state budget, downgraded the state’s bond rating, and slowed job growth to a much lower rate than the national average. Brownback, once thought to be a strong contender for the 2016 Republican presidential nomination, now has just a 48 percent chance at being elected to a second term, and his tax cuts are the central issue of the campaign. These tax cuts have been devastating for Kansas’ disabled population.
Since Brownback’s inauguration, 1,414 Kansans with disabilities have been forced off of the Medicaid physical disability (PD) waiver. In January of 2013, Brownback became the first governor to fully privatize Medicaid services, claiming he would save the state $1 billion in 5 years without having to cut services, eligibility, or provider payments. Now, under Brownback’s “KanCare,” PD waiver cases are handled by for-profit, out-of-state, Fortune 500, publicly-traded managed care services. Kansas has contracts with three managed care profiteers — United Healthcare, Sunflower State Health Plan (owned by Centene Corporation), and AmeriGroup. Amerigroup and Centene each gave $2,000, Kansas’ maximum allowed contribution, to Brownback’s re-election campaign.
“They wanted to cut my full-time care hours by 76 percent, which all three of my doctors said was totally unrealistic,” said Finn Bullers, a disability rights advocate who suffers from muscular dystrophy, uses a wheelchair, has type 1 insulin-dependent diabetes, and requires a ventilator in his throat to breathe. “Essentially, they wanted three out of every four hours to go away.”
“Often, these are not optional services,” said Rocky Nichols, executive director of the Kansas Disability Rights Center. “These are life-sustaining services like properly caring for and cleaning out feeding tubes, colostomy bags, and other devices so people don’t die, transferring the person with a mobility impairment from the chair so they can toilet, assisting with the critical and life-sustaining activities of daily living that most of us take for granted. These are basic human needs, not optional wants.”
But Brownback’s claims of savings without risking patient eligibility is mere sleight of hand when taking a closer look at the numbers. When Kansas experienced a $217 million revenue shortfall in April of 2014, Brownback actually broke a promise made to the federal government as to how many people with disabilities would be served. When applying to launch the KanCare program, the Brownback administration originally promised the U.S. Department of Health and Human Services it would accommodate 7,874 people on the PD waiver, according to numbers from the Kansas Department for Aging and Disability Services. After the first revenue shortfall, Brownback changed that number to 5900 – nearly a 25 percent cut in services amounting to $26 million.
Just before Brownback’s inauguration, Kansas served 6,752 people on the PD waiver. More than 2,000 people with disabilities were added just in the last decade as a result of more advanced healthcare and disabled people living longer lives. However, the gradual uptick in new enrollees stopped abruptly once Brownback took over. According to this chart, over 1,400 disabled Kansans were dropped from the waiver between 2010 and 2014, with a sharp decline in 2014, coinciding directly with the revenue shortfalls resulting from the recent tax cuts.
“It is mind-boggling to think that in 2004, just ten years ago, there were 4,527 people on the waiver… It grew to 6,752, and it’s been in a death spiral ever since then,” Nichols said. “That cannot be an accident. There is just no way you can have, year after year, for four years in a row, those types of reductions in the number of people served.”
According to one state elected official, the sudden drop-offs could easily be traced back to Brownback’s tax cuts and privatization agenda. State Senator Laura Kelly, ranking member of the public health and welfare committee, said it’s no coincidence that the physically disabled are having life-sustaining services cut with the inception of KanCare and the drops in state revenues.
“I think it’s hard to divorce the tax cuts from anything that’s happening in Kansas’ state government,” Sen. Kelly said.
If Brownback’s income tax plan is to be fully realized and the state of Kansas has a 3.9 percent income tax rate by 2018, Kansas will have lost $5 billion in tax revenue. To put that in perspective, Kansas currently operates on an $8 billion state budget. Advocates like Bullers say if state revenues continue to plummet, so will the number of people on the PD waiver.
“I don’t want to use hyperbole, but a lot of people die when these policies get implemented,” Bullers said.
Bullers, a former 15-year veteran reporter for the Kansas City Star and father of two, fought from the time of his managed care review in January of 2013 all the way to New Years Eve of 2013 for his full-time care to be restored. He used his status as a public figure in Kansas to organize awareness campaigns in both traditional and social media, and even arranged a meeting with Gov. Brownback. Bullers said he “got really pissed off” at Brownback’s response to a question he asked about not having a home care provider available if his ventilator came loose, stopping air from getting into his lungs.
“He said, ‘Just go over to your neighbor’s house and they’ll put it back on for you,’” Bullers said. “I mean, here’s the governor of the state of Kansas, telling me that, you know, your life isn’t worth it, that it’s okay if you die and leave two small children without a father.”
A 2006 Rolling Stone profile of then-U.S. Senator Brownback referred to him as “God’s Senator,” in reference to Brownback’s outspokenness about his Christian faith. But Bullers described Gov. Brownback as “vengeful” and “hypocritical,” saying Brownback didn’t adhere to Jesus’ teachings about caring for the poor and the sick.
“We hear all the time about his ‘family values’ and how he’s a churchgoer,” Bullers said. “You just have to ask yourself where the Golden Rule plays into all this.”
Brownback’s Democratic challenger, Paul Davis, has said Brownback’s privatized approach to Medicaid “isn’t working very well” and promised a full top-to-bottom review of KanCare if elected. Davis has also promised to expand Medicaid in Kansas under the Affordable Care Act if he wins on November 2, something Brownback has steadfastly refused to do. As of mid-October, Brownback has left $350 million on the table in Medicaid assistance from the federal government as a result.
“He would rather have people suffer than capitulate and admit the president didn’t do such a bad job,” Bullers said.