Kansas state employees retain choice of Blue Cross, Aetna for health insurance

TOPEKA — Kansas state employees can choose between two health insurance companies after the Health Care Commission voted Monday to move forward with Aetna and Blue Cross Blue Shield of Kansas.

Commission members debated whether to choose Aetna, dropping Blue Cross, for the state's health insurance beginning Jan. 1, 2027, to save an estimated $240 million over the three-year contract.

Several commissioners said the decision wasn't just about saving dollars. Cristi Cain, who represents state employees on the commission, said she received "significant feedback" on retaining Blue Cross.

"One thing that was pointed out is an overwhelming number of employees choose Blue Cross — 34,500 to 4,500 for Aetna — which means about 90% of employees choose Blue Cross, when given the option," she said. "As one employee put it, 90% of employees cannot be wrong, and our opinion and voices should be counted, respected and valued."

Many comments focused on retaining choice, concerns about continuity of care and whether Aetna has a good provider network in rural areas, Cain said. Employees shared personal stories, including a woman with two children who are medically complex, one of whom received surgery in Baltimore recently, she said.

"Blue Cross case managers have helped coordinate medical supplies and care, preventing extended hospital stays," Cain said. "She stated clearly if the choice were between losing Blue Cross or paying higher premiums, we would choose to pay more without hesitation."

Proposals put forth at the meeting included extending the current contract for one year and putting it out for bid again or dropping the three-year contract to one year, which would give commissioners more time to assess effects on state employees.

The insurance companies would have to agree with either one of those actions, since the "request for proposal" was for a three-year contract, commission staff said.

However, Rep. Bill Sutton, a Gardner Republican who serves on the committee, said he didn't see the point of either option. He said from what he had heard that morning, he believed the commission didn't want to cause disruption for employees.

"Even in the face of saving $220 million, we would rather go into the next meeting and decide what co-pays we're going to increase, what coverage we're going to reduce, what premiums we're going to increase in order to keep our plan solvent," he said.

Sutton said he thought the commission's purpose was to get a bid that offered the best deal for Kansas employees.

In its June meeting, the commission will look at overall design for the state healthcare plan, determining what changes need to be made to co-pays, premiums and other costs.

Commission chairman and administration secretary Adam Proffitt proposed approval of both companies and for the commission to consider setting different monthly employee rates based on which company they chose. Because Aetna would cost less, it is likely some employees would move to that company, which could save costs for the state, he said.

Proffitt also said the $240 million was not an increase in costs if they chose not to go with Aetna alone. It is a "hypothetical" savings, and there is a question whether Aetna will be able to expand its provider network to ensure good coverage throughout the state, he said.

"So it's a leap of faith," he said. "In my estimation, that increase we're looking at for next year is only 2.74% … and that is pretty close to what the target rate of inflation is," Proffitt said.

Moving forward with both would essentially maintain the status quo, he said.

Proffitt's proposal passed with five votes of approval and one abstention from Insurance Commissioner Vicki Schmidt.

Sutton said he liked the idea of tiered pricing so that employees who didn't want to pay for Blue Cross would have a less expensive option.

Schmidt said she wanted the request for proposal to be put out again, so that it could be structured better. She said she still didn't have answers for all the questions about the proposals that she would like to have.

"I do think that when you have such a vast range between the two bids, there's something that just doesn't look right," she said.

Schmidt said she is concerned about state employees, about the reserve fund, "which is in the gutter," and how making up the difference either will cost state employees through premiums or the state general fund.

"I don't think either one of those are good choices, and I think it should have gone back for rebid and take a look at it and see what happened," she said.

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