GARNETT, Kan – Two Kansas teens were injured in an accident just before 5 p.m. on Friday in Anderson County.

The Kansas Highway Patrol reported a 2001 Ford Taurus driven by Jessica Pollitt, 18, Olathe, was northbound on U.S. 169 one mile north of the business junction and traveled off the right side of the roadway.

The driver overcorrected and the vehicle overturned.

Pollitt and a passenger Avery Pollitt, 16, Overland Park, were transported to Anderson County Hospital.

The KHP reported they were properly restrained at the time of the accident.

TOPEKA, Kan. (AP) — Independent candidate Greg Orman has outlined proposals for helping veterans as he campaigns against Republican Sen. Pat Roberts in Kansas.

Orman had a Statehouse news conference with several veterans Friday to tout his initiatives. They include a loan program to help tide over veterans who are waiting to receive disability payments.

The independent candidate also said the federal government needs to act to protect veterans from predatory loans for higher education. He said steps include forgiving some loans and greater resources to investigate abuses.

Orman also proposed expanded federal funding for special courts aimed at providing treatment rather than prison for veterans with legal problems and expanded efforts to combat homelessness among veterans.

Roberts is a former Marine who has touted his past work on national security issues and military projects.

DOUG ESSER, Associated Press
MARTHA BELLISLE, Associated Press

MARYSVILLE, Wash. (AP) — A student recently crowned freshman class Homecoming prince walked into his Seattle-area high school cafeteria Friday and opened fire, killing one person and shooting several others in the head before turning the gun on himself, officials and witnesses said.

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DOUG ESSER, Associated Press

MARYSVILLE, Wash. (AP) — A hospital says three victims are in critical condition after a school shooting near Seattle.

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MARYSVILLE, Wash. (AP) — Police say a lone shooter is dead after an attack at a high school north of Seattle.

Marysville Police Commander Robb Lamoureux (LAM’-or-oh) said the shooter was a student, but he did not have any additional information including where in the school the shooting took place and if anyone else was killed or wounded.

Many students and staff members were seen walking out of Marysville Pilchuck High School, about 30 miles north of Seattle, after police and ambulance crews surrounded the campus. Lamoureux said police were going room by room, searching the school to make sure it was safe.

There were conflicting reports about the number of possible injuries. A spokeswoman at Harborview Medical Center in Seattle, said the facility was expecting one patient but had no other information.

HUTCHINSON, Kan. (AP) — A crowd-sourcing website aimed at helping Kansas communities has gone live with its first four projects.

Kanstarter is powered by the Kansas Sampler Foundation. The site, which went live Thursday, allows people to donate time, talent or money to the projects.

The Hutchinson News reports the four projects on Kanstarter all have a common theme of improving Kansas rural life. One project is aimed at helping Burdett update its public miniature golf course. Another wants to help Plains purchase land to build a grocery store.

The foundation’s director described the website launch as soft, since the projects are new and everyone involved is still in the learning process.

The foundation received $200,000 in community service tax credits from the state’s commerce department to build the website.

By Jim McLean
KHI News Service

LAWRENCE — Which of the following is true:

• The Affordable Care Act has provided thousands of low-income Kansas with greater access to affordable health insurance.

• A looming ACA mandate has caused some Kansas employers to hire fewer full-time workers and instead fill positions with part-time employees.

• The combination of reductions in Medicare rates and the state’s decision not to expand Medicaid eligibility has put Kansas hospitals in a financial bind.

The correct answer is “all of the above.”

Less than a year after the first plans were sold in the Obamacare marketplace, it’s clear that the law’s impact on consumers, providers and employers has been mixed. But it’s also clear that it’s too soon to fully gauge its impact.

“There is so much uncertainty going forward,” said economist Donna Ginther, wrapping up the 2014 Kansas Economic Policy Conference on Thursday at the University of Kansas.

Consumers are hopeful but confused. Employers are wary. Health insurers are shooting in the dark. And providers – particularly rural hospitals – are worried about surviving as they transform the way they deliver care.

“It’s really hard if you’re a provider out there … with one foot on the dock and one foot on the boat,” said Kansas Hospital Association President and CEO Tom Bell, referring to the difficulties that hospitals face transitioning from the old fee-for-service system to one that requires providers to manage the health of their patients.

Arthur Frable, CEO of the Bob Wilson Memorial Grant County Hospital in Ulysses, said creating a value-based system that rewards providers that meet certain quality measures and penalizes those that don’t can be a “very scary” proposition for rural providers serving higher proportions of elderly Kansans who require more acute care.

“My concern is that ultimately this is going to be the mechanism that’s going to be used to close many hospitals,” Frable said.

Insurers guessing on rates

The transition also continues to challenge Blue Cross Blue Shield of Kansas, the state’s largest health insurer, said Matt All, senior vice president and general counsel. The company had to set premiums for the plans it will offer during the upcoming Obamacare enrollment period before it knew whether it had properly priced plans sold during the first round.

“There is a lot of guesswork going on,” All said. “It’s reasonably educated guesswork. But it’s guesswork all the same.”

The next open enrollment period starts on Nov. 15 and runs through Feb. 15, 2015.

During the first enrollment period, Oct. 1, 2013, to March 31, 2014, more than 57,000 Kansans purchased coverage through the online marketplace. About 78 percent of them received federal tax credits, meaning their incomes ranged between 100 percent and 400 percent of the federal poverty level. More than half of the almost 45,000 Kansans who received subsidies paid $50 or less per month for their coverage, according to a new report from the Kansas Health Institute, the parent organization of the editorially independent KHI News Service.

The number of Kansans who purchased coverage in the marketplace and previously were uninsured is unknown, but it’s estimated that nationally about 30 percent of those who purchased Obamacare plans previously lacked coverage.

Arkansas Medicaid expansion touted

Many states have significantly reduced their uninsured rates by expanding Medicaid eligibility to 138 percent of FPL – about $16,104 of annual income for an individual and $32,913 for a family of four. Arkansas engineered one of the biggest reductions.

“Arkansas had the seventh highest uninsurance rate in the country before this. We have now experienced the largest single percentage reduction in uninsurance in the country,” said Andy Allison, a former Kansas Medicaid official who spearheaded the expansion effort in Arkansas as director of that state’s program.

The Arkansas plan, which provides private coverage to 90 percent of new enrollees and leaves the 10 percent with the most serious health issues in traditional Medicaid, has served as a model for other “red” states where most elected officials are opposed to the ACA.

The infusion of young and relatively healthy Medicaid recipients into Arkansas’ private insurance market is pushing down rates for everyone else, Allison said.

“We’ve just made private insurance in Arkansas for people above 138 percent (of FPL) cheaper,” Allison said, estimating that 2015 premiums will average 2 percent less than those charged in 2014.

Bell, of the Kansas Hospital Association, said the organization is drafting a Medicaid expansion proposal for the 2015 legislative session that likely will include some features of the Arkansas plan. He said he hopes that after the election the governor – whoever that turns out to be – and lawmakers will be ready to discuss expansion.

Failure to act, Bell said, will leave more than 80,000 low-income adults in a kind of insurance limbo. They make too much for Medicaid but too little to be eligible for subsidies in the Obamacare marketplace.

“To me that’s a head-scratcher,” Bell said. “It raises the question of why we as a state are not having an official conversation about what can we do to help the people out in that bubble.”

However, if Rep. David Crum’s comments are any indication, many conservative Republicans may continue to oppose expansion on the grounds that its cost is not sustainable until Congress reforms entitlement spending.

“The idea that programs funded by the federal government are free has contributed to our $18 trillion federal debt,” said Crum, an Augusta Republican who is not running for re-election. “Until Congress can fix our entitlement system and balance our budget, I worry about expanding the Medicaid program.”

Under the ACA, the federal government has agreed to pay all expansion costs for three years. After that the federal share will gradually decline until it reaches 90 percent, where it will remain.

KANSAS CITY, Kan. (AP) — A federal judge has spurned an effort by a heterosexual couple to intervene in a lawsuit challenging the Kansas ban on gay marriage.

U.S. District Judge Daniel Crabtree ruled Friday that Phillip and Sandra Unruh, of Harper, have no legal right to join the lawsuit filed by the American Civil Liberties Union of Kansas.

The Unruhs claimed in a Wednesday filing that they have a property right in their traditional marital status. They argued an adverse decision on the constitutionality of the state’s same-sex marriage ban could diminish their marital status and harm their property right.

Crabtree concluded the Unruhs’ interests are already represented by the Kansas attorney general’s office, which is defending the ban.

But the judge also invited the couple to file a friend-of-the-court brief stating their arguments.