From the Kansas Health Institute:
Insurer only MCO to report no expenses for Kansas legislator meals in 2016
For the second year in a row, UnitedHealthcare reported no lobbying expenses during the Kansas legislative session.
The insurance company remained the outlier among the three under contract to administer KanCare, the privatized form of Medicaid that Kansas adopted in 2013.
Amerigroup reported spending $1,709.51 while lobbying legislators in January through April of this year. Sunflower State Health Plan and its parent company, Centene, reported spending a combined total of $4,416.11 in the same time period. The session adjourned early on May 2.
The Kansas Governmental Ethics Commission collects lobbyist data. The itemized spending that the three managed care organizations, or MCOs, reported was for meals and drinks for legislators and their staff members.
Kansas has relatively strict limits for material gifts from lobbyists but allows for unlimited spending on food and drinks, and lobbyists use the meals to gain “face time” with policymakers.
Jessica Buechler, director of public relations for UnitedHealthcare Community & State, had little to say about the company’s lack of lobbying in Kansas.
“We engage with policymakers on issues that impact the people we serve, and comply with all applicable state lobbying laws regarding these activities, including reporting on expenses,” she said.
Last year a UnitedHealthcare spokeswoman said the company meets with legislators during office hours.
All three companies retain lobbyists who are well-connected in the Kansas Capitol. UnitedHealthcare’s team includes Riley Scott, Senate President Susan Wagle’s son-in-law, and Wade Hapgood, House Speaker Ray Merrick’s former chief of staff.
Centene retains Matt Hickam, who previously partnered with David Kensinger, Gov. Sam Brownback’s former chief of staff. Amerigroup retains Gary Haulmark, a former official with what is now the Kansas Department for Aging and Disability Services.
Combined, the three companies hold Medicaid contracts worth about $3 billion annually in state and federal money.
The five-year contracts are set to expire in 2018, and state officials are crafting an extension application to send to the federal Centers for Medicare and Medicaid Services.
Amerigroup lobbying down, Centene up
Amerigroup’s lobbying total was down more than $1,000 from last year, but this year’s legislative session was about 40 days shorter.
Haulmark devoted much of his lobbying attention to Rep. Dan Hawkins of Wichita and Rep. Willie Dove of Bonner Springs, the two Republicans who lead the House Health and Human Services Committee.
Haulmark reported 12 meals with Dove and 10 with Hawkins. No other lobbyist took Dove or Hawkins to more than four meals. Hickam and Jim Gardner, Sunflower State’s contract lobbyist, took Hawkins to four each.
MCO lobbyists reported spending $465.43 on meals for Hawkins, which was less than half what they spent last year on the chairman of the House health committee but still topped all legislators.
With the Senate Public Health and Welfare Committee’s leadership in flux, MCO lobbyists spread their spending on that chamber.
Senate Majority Leader Terry Bruce, a Republican from Nickerson, was the Senate’s top recipient of MCO lobbying expenses, with $337.65 worth of food and drinks.
Despite the shortened session, Centene and Sunflower State combined to spend slightly more on lobbying in 2016 than last year.
Dove said MCO lobbyists wanted to talk with him this year about a number of issues, including step therapy and the state’s overall budget picture.
“Yeah, step therapy was one of them,” he said. “They just wanted to give some information on that they thought would be helpful.”
Dove said that included information on the prevalence of the policy that allows insurance companies to require that patients try cheaper prescription drugs before “stepping up” to more expensive treatments. It is part of Medicare and many private insurance plans.
Based on his budget conversations with the MCO lobbyists, Dove said he knows that recent budget cuts to Medicaid hurt.
“But they also understand the state revenue is going through some trials, and they want to do everything they can to help,” Dove said.
UnitedHealthcare still involved
Dove said he has talked with UnitedHealthcare lobbyists Scott and Hapgood about MCO issues during the session, just not over dinner or drinks.
“Sometimes we’ll just have a conversation in general about it,” Dove said.
In addition to its growing slate of Medicaid holdings in states like Kansas, Arizona and Delaware, UnitedHealthcare is the largest provider of private-sector insurance plans in the country.
The insurance giant broke with its counterparts on lobbying last year when it decided to leave America’s Health Insurance Plans, a trade group active in state and national politics.
UnitedHealthcare executives said they thought the trade group was no longer representing the company’s best interests.
Wendell Potter, a former insurance executive who has gained national prominence as a critic of the industry’s lobbying clout, said in a phone interview that UnitedHealthcare’s size means it doesn’t have to wine-and-dine legislators to influence policy.
“They have enormous sums of money they spend to influence public policy, so it could be they’re just doing it in different ways that are not direct lobbying,” he said. “That’s what I suspect is happening.”
UnitedHealthcare has been the most financially successful of the three MCOs in the early years of KanCare, but all have struggled to turn a profit.
The nonprofit KHI News Service is an editorially independent initiative of the Kansas Health Institute and a partner in the Heartland Health Monitor reporting collaboration. All stories and photos may be republished at no cost with proper attribution and a link back to KHI.org when a story is reposted online.
