While serving as Kansas’ state insurance commissioner, Kathleen Sebelius was credited with helping promote legislation requiring mental health parity for state-regulated insurance policies. And as governor, she regularly pushed for bills that would widen access to healthcare for Kansans.
So you might think that behavioral healthcare advocates in the Sunflower State would sing their former governor’s praises now that she has been sworn in as secretary of the U.S. Department of Health and Human Services.
Yet community mental health centers (CMHCs) in Kansas went through several budget disputes with the Sebelius administration involving changes to Medicaid and grant funding.
“I think it is fair to say she was not very accessible to us as governor,” says David Johnson, CEO of the Bert Nash Center in Lawrence and past-president of the Association of Community Mental Health Centers of Kansas. “Perhaps our expectations were too high when she became governor. In that role she had much wider interests, including other aspects of healthcare.”
In 2007, as Kansas was forced to increase state matching funds for Medicaid, it cut several million dollars of grant funding for the state’s 27 licensed CMHCs, which are required to provide services to the uninsured and those who don’t qualify for Medicaid.
“As the budget got tighter, the administration cut some of the grant funding, arguing that mental health centers could use Medicaid money to make up for it,” Johnson explains. “I think it was just a lack of education on their part about what the real costs are.”
It’s not clear whether those funding battles suggest anything about how Sebelius will approach behavioral health issues as HHS secretary. In Kansas she was a Democratic governor working with a Republican legislature on very difficult budget issues.
Current Kansas Insurance Commissioner Sandy Praeger remembers that Sebelius testified in support of mental health parity legislation in 2001.
“She was 100% behind that effort,” Praeger recalls.
She adds that Sebelius’ experience as both an insurance commissioner and a governor gives her a good understanding of the role of private insurance and Medicaid in behavioral healthcare and the infrastructure that needs to be in place for the system to work well.
Others are eagerly waiting to see how Sebelius will approach behavioral health issues in her new role.
“From a mental health standpoint,” Johnson notes, “I am more excited about working with her as secretary of HHS than I was about working with her as governor.”
David Raths is a freelance writer.