By Jonathan Shorman
May 16, 2016

Gov. Sam Brownback signed legislation into law Monday that further restricts welfare assistance and requires Medicaid patients to try less expensive drugs first before moving to more costly medications.

The bill contains the most expansive public assistance and health policy changes passed by the Legislature this spring and was strongly opposed by Democrats and social welfare organizations.

Brownback hailed the package as helping to move people out of poverty. His administration argues previous restrictions have spurred individuals to leave welfare and seek jobs — pointing to drops in the number of people receiving assistance.

“It’s been very positive in its results. It’s helped people get out of poverty, it’s helped people have more income, and in some cases it’s helping people get back their dignity,” Brownback said.

The new law reduces the benefit limit for temporary assistance for needy families from 36 calendar months to 24 months. The lifetime benefit limit is also lowered to 36 months from 48 months.

The reduction is expected to take about 424 households off assistance in the next year, according to the administration. About 4,400 households receive assistance now.

Brownback referred to what he views as the human nature to procrastinate when asked about the reasoning behind the time-limit reduction. Other speakers at a bill signing ceremony Monday also said no one wants to be on public assistance his or her whole life.

“That’s our objective: it’s to get people out of poverty,” Brownback said.

Brownback has said Kansas has a high percentage of welfare recipients who are also working: 38 percent, according to 2014 data, the latest year available.

Of those who left welfare, however, only 8.4 percent cited employment as the reason they stopped receiving assistance. By contrast, 31 percent said they stopped receiving benefits because of a work-related sanction.

“Who wants to stay on government assistance all their life? There’s really nobody that wants to do that. So that’s what this is all about: getting people back on their feet, getting them back into the workforce, getting them to be proud of being self-sustaining,” Rep. Dan Hawkins, R-Wichita, said.

Under the new law, the Department for Children and Families will also place individuals who seek four or more replacement benefit cards in one year under greater scrutiny for potential suspicious activity.

The agency will also be required to verify the identity of all adults in a household receiving assistance. And if individuals who win lottery prizes of more than $5,000 are welfare recipients, the state will review them to see if they remain eligible for assistance.

Opponents have said the legislation will harm the ability of individuals to climb out of poverty. Welfare restrictions have blocked vulnerable children and families from accessing the public safety net, Kansas Action for Children argues.

Reported child homelessness has risen since 2007, and at the same time fewer children are participating in the state’s cash assistance program. The number of children receiving cash assistance has fallen from more than 25,000 in 2007 to a few more than 10,000 in 2015.

“For six years, Governor Brownback has declared a commitment to reducing childhood poverty, which makes it to difficult to reconcile this policy decision,” KAC president and CEO Shannon Cotsoradis said.

“The so-called HOPE Act hurts the poorest families in Kansas. Even parents who have found jobs may not be earning enough to feed their families. Cutting off critical lifelines to Kansas’ most economically fragile children merely perpetuates the cycle of poverty that the Governor claims to be committed to reducing.”

The bill also implements so-called step therapy, which allows the Kansas Department for Health and Environment to require state Medicaid patients to use the most effective, least expensive drug first before transitioning to more expensive drugs. The physician prescribing the patient’s medications can seek to override the requirement, however.

A doctor can utilize an expedited override process if the drug is expected to be ineffective, the patient has already tried the drug or the patient has previously been found to be stable on a different drug. The decision on an expedited override request must be made within 72 hours.

Sen. Laura Kelly, D-Topeka, said she appreciated efforts to place patient safeguards into the bill but fears they won’t be enough.

“I am confident somehow the administration will find a way around those and do exactly what they want to do,” Kelly said.

Senate Minority Leader Anthony Hensley, D-Topeka, calling the bill a “double-edged sword,“ also questioned whether the legislation may run afoul of rules designed to limit bills to one subject. He indicated he may consult with the Attorney General’s office on the bill’s constitutionality.

The Legislature approved the legislation, Senate Bill 402, on the last day of the session. The House approved the measure 79-43, and the Senate voted 27-13 to pass the bill.

Read more from the Topeka Capital Journal.