Division of the Budget
Landon State Office Building Phone: (785) 296-2436
900 SW Jackson Street, Room 504 adam.c.proffitt@ks.gov
Topeka, KS 66612 http://budget.kansas.gov
Adam C. Proffitt, Director Laura Kelly, Governor
Division of the Budget
February 7, 2025
The Honorable Beverly Gossage, Chairperson
Senate Committee on Public Health and Welfare
300 SW 10th Avenue, Room 142-S
Topeka, Kansas 66612
Dear Senator Gossage:
SUBJECT: Fiscal Note for SB 198 by Senate Committee on Public Health and Welfare
In accordance with KSA 75-3715a, the following fiscal note concerning SB 198 is
respectfully submitted to your committee.
SB 198 would prohibit abortion procedures except when necessary to preserve the life of
a pregnant woman in a medical emergency. The bill would make relevant definitions and update
statutory references to the term “abortion.” In addition, the bill would identify certain exceptions
and provide for private civil enforcement actions.
According to the Kansas Department of Health and Environment (KDHE), enactment of
SB 198 could result in a loss of federal Title X funding. This funding totals $2.9 million for FY
2025, $3.5 million for FY 2026, and $4.1 million for FY 2027. Additional state funding would be
necessary to maintain current services. This includes approximately $301,842 for various levels
of funding for 12.00 positions (ranging from 5.0 percent to 100.0 percent of the salary). KDHE
reports that the passage of similar legislation in Oklahoma and Tennessee resulted in the removal
of federal Title X funding, because of the determination that these states were then unable to
provide abortion counseling and referrals, which is a programmatic requirement as part of a 2021
Final Rule. Loss of federal funding would also result in local health departments losing access to
340B reduced prescription costs, which would result in an additional need for increased funds to
deliver the same level of care and continuation of access to high quality reduced cost
contraceptives and reproductive health services.
Title X is a federal grant program that provides Family Planning and Reproductive Health
services to individuals regardless of income. The agency notes that family planning includes a
broad range of services related to achieving pregnancy, preventing pregnancy, and assisting
women, men, and couples with achieving their desired number and spacing of children and can
include contraceptive care, STD/STI screenings and treatment, cancer screenings, basic infertility
services, and more. Currently approximately 13,000 Kansans receive these services, usually at
clinics housed in a local health department. The agency states that county health departments and
rural communities would take the brunt of the impact of a loss of federal funding as they are The Honorable Beverly Gossage, Chairperson
Page 2—SB 198
required to maintain a 40.0 percent match to the federal dollars supplied by the Title X grant.
Without the federal funding, they would be required to fully fund the same services offered in
addition to the increase in pharmaceutical costs from losing their 340B status. KDHE states this
would result in many counties being unable to continue to provide adequate services due to the
financial burden. This would increase the burden to those rural and frontier areas as well onto
neighboring cities and counties to accommodate patients from farther distances as many rural areas
already experience shortages in health care providers and services.
The Office of the Attorney General estimates that enactment of SB 198 could increase
litigation costs for defense of the law. The Offices estimates $4.5 million would be needed in FY
2026 and $512,672 would be needed in FY 2027, all from the State General Fund. This would
include the hiring of outside counsel and increasing internal staff by 2.00 attorney positions and
2.00 legal assistants. The estimated salaries and wages would be $133,905 for each attorney and
$63,755 for each legal assistant. In addition, technology, training, and other administrative costs
for these positions would total approximately $92,940.
The Office of Judicial Administration states enactment of SB 198 could increase the
number of cases filed in district courts because it allows for civil suit to be filed. This could result
in more time spent by judicial and nonjudicial personnel processing, researching, and hearing these
cases. The Office estimates enactment of the bill could result in the collection of docket fees and
fines assessed in those cases filed under the bill’s provisions, which would be deposited to the
State General Fund. The bill would not affect other revenues to the Judicial Branch. However, a
fiscal effect cannot be estimated.
The Board of Healing Arts notes that the bill would prohibit enforcement by state agencies
so there would not be a fiscal effect for the agency. The Kansas Board of Pharmacy reports that
enactment of the bill could result in an increase in complaints or investigations, but no fiscal effect
is anticipated. The Kansas Department of Revenue and the University of Kansas Medical Center
report that the bill would not result in a fiscal effect for either agency. Any fiscal effect associated
with SB 198 is not reflected in The FY 2026 Governor’s Budget Report.
Sincerely,
Adam C. Proffitt
Director of the Budget
cc: Alexandra Blasi, Board of Pharmacy
Susan Gile, Board of Healing Arts
Amy Penrod, Department of Health & Environment
Matt Bingesser, Office of the Attorney General
Trisha Morrow, Judiciary
Jeff Dewitt, University of Kansas
Lynn Robinson, Department of Revenue