Republican gubernatorial candidate Jim Barnett demanded proof Tuesday of Gov. Jeff Colyer's assertion that privatization of Medicaid with three for-profit insurance companies enabled the state to avoid $2 billion in expenditures and improved health outcomes for hundreds of thousands of Kansans.

Barnett said the Colyer campaign's portrayal of KanCare as a privatization success was "quite a whopper." In rebuttal, the Colyer campaign questioned Barnett's capacity to grasp complex subjects.

Barnett, a practicing physician along with Colyer, alleged the governor misled potential voters in campaign speeches by claiming outsourcing of Medicaid "saved $2 billion," despite lack of independent evidence KanCare moved the dial to such an extent.

"Colyer’s claim starts with projections for state spending that are way beyond the historical norm, adds in potential federal funds based on this imaginary spending, mixes them together and, voila, the supposed savings. This is an approach that would make big government progressives proud," Barnett said.

Kendall Marr, a spokesman for Colyer, said intent of Medicaid reform implemented in 2013 was to bend the projected cost curve down. Savings were to be realized through cost avoidance rather than reductions in actual spending, he said. Marr stood by the $2 billion figure shared by Colyer because it reflected savings from what would have been incurred without change under the old Medicaid system.

He also said access to preventative care expanded and health outcomes improved under KanCare at the same time the number of people enrolled in the system moved from 385,000 in 2012 to nearly 430,000 in 2017.

Colyer, who took office five months ago after the resignation of Gov. Sam Brownback, directed Cabinet agencies to seek solutions to persistent flaws with the managed-care system, Marr said. For example, KanCare has been plagued for years by problems enrolling participants and promptly reimbursing providers.

"If Jim Barnett’s antics today are any indication, Kansans would be sorely disappointed in the accuracy of a Barnett governorship," Marr said. "Study after study has indicated KanCare has saved state and federal taxpayers money while also increasing access to primary care."

However, Barnett said savings claimed by Colyer was "no more real than the jobs we were promised as part of the Colyer-Brownback tax plan."

Barnett said the state's spending on Medicaid from 2012 to 2016 surged 22 percent. By comparison, he said, Oklahoma's allocations for Medicaid went up 3.7 percent during that period. The increase in Missouri was 13.5 percent and Nebraska's increased 16.5 percent.

In 2016, Barnett said, the Kansas Department of Health and Environment found the program wasn't meeting quality-of-care goals. KanCare was placed during 2017 under federal oversight for "delayed and inadequate care," Barnett said. In April, the Legislature's auditors reported it was impossible to make credible conclusions about patient outcomes because records were inadequate.

Barnett is a proponent of expanding eligibility for Medicaid under the Affordable Care Act, but Colyer and Brownback opposed extension of primary medical care to 150,000 more Kansans.

"Governor Colyer is bringing harm to Kansas. Both Dr. Colyer and I took the same oath-first do no harm. His policy decisions are wrong," Barnett said.