EMILY SCHMALL, Associated Press

FORT WORTH, Texas (AP) — Enrollment drives are being held across the country to help people beat Sunday’s deadline to sign up for health insurance through the federal marketplace.

But in Texas and nearly two dozen other states where millions of people fall into a so-called coverage gap, the outreach effort has involved more than just signups.

Nonprofits and other health groups are making sure these people know what steps to take to avoid a federal penalty for not having insurance.

About four million Americans fall into the coverage gap, earning too little to qualify for federal subsidies for private insurance but too much for Medicaid.

People in the gap can file for hardship exemptions. The U.S. Treasury estimates between 10 and 20 percent of taxpayers will claim an exemption.

By ASHLEY BOOKER

For Les Snyder, it’s not difficult to drive through Kansas and point out massage therapy businesses that are most likely fronts for the sex trade.

Snyder, the regional developer for Massage Envy Spa, said his tactic is to go through the front door and ask to make an appointment. If the employees look at him oddly and say they can take him back that instant, that’s a red flag.

“That is not common business in this industry,” Snyder said. “It’s just a piece of a puzzle. Could you take that to court? Absolutely not.”

Snyder oversees Massage Envy’s operations in Kansas, Nebraska and Missouri. He has stepped into about six Kansas locations he thought weren’t legitimate, and he believes half of them were providing more than just therapeutic massage.

He doesn’t see that as regularly in Nebraska and Missouri, which require a license to practice massage therapy. Kansas is one of only five states that do not require such a license.

A bill being considered seeks to change that for the estimated 2,500 Kansans who work as massage therapists.

While some people say not requiring a license keeps the industry open and fosters competition, others believe Kansas should have some standards for who can work as a massage therapist.

There’s also debate about whether a state licensure bill would effectively crack down on massage parlors being used as a cover for the sex trade, or if that should be left to local law enforcement.

‘Basic standard’

The Kansas chapter of the American Massage Therapy Association has been working on licensing legislation for eight years. That work culminated in Senate Bill 40, which had a hearing last week in the Senate Public Health and Welfare Committee.

The same licensure bill, House Bill 2123, has been introduced in the House and had a committee hearing this week.

“We are seeing people migrate to Kansas as more states become licensed,” said Marla Hieger, government relations chair and immediate past president of the Kansas Chapter of the American Massage Therapy Association. “They may be involved in trafficking or in some other form of prostitution. The licensure will help discourage that.”

Studies have shown that massage, when done correctly, has a number of health benefits. But when done by untrained hands, a massage can carry health risks.

That’s all the more reason to require licenses, Hieger said.

“If we are going to be working with health care, there should be some basic standard,” she said.

The bill would require all massage therapists to have a license under the Kansas State Board of Nursing and pay for a licensing fee, yearly continued education and liability insurance.

Current practicing massage therapists may be grandfathered if they meet requirements before July 2017. After that, they must pay the fee and participate in continued education.

Opponents of the bill said the regulation isn’t needed and may hurt the massage industry.

They voiced concerns about the wording of the bill, the makeup of a proposed Massage Advisory Committee and the fact that local governments couldn’t set their own requirements or licensing.

The bill would establish a massage therapy advisory committee with six members: two from the board of nursing and four non-board members. Three of the four would be massage therapists in Kansas, one of whom may be a massage school owner. The Kansas attorney general would designate the fourth non-board member.

Snyder, the Massage Envy developer, said the state licensing board and the professional standards it would bring would benefit Kansas.

But Lynn Stallard, a self-employed Topeka massage practitioner for more than 30 years, said massage school owners would have a conflict of interest in determining training and continuing education requirements.

“Any owner of a massage school stands to benefit from this bill financially,” she said. “That leaves two massage therapists to represent all of us.”

Most massage therapists in the industry don’t have a formal education, Stallard said. She asked legislators to amend the bill so at least one person without a 500-hour education — the minimum required in training programs — could sit on the board for the first two years.

Idaho was the last state to pass a bill to require massage therapy licensure.

Wayne Hoffman, president of the Idaho Freedom Foundation, a free-market advocacy group, said that was a mistake.

After the bill was signed by Gov. Butch Otter in 2012, Hoffman wrote an editorial saying that licensure is a barrier to the marketplace, drives up massage costs by making fewer therapists available, adds new costs to the profession and won’t stop prostitution.

“It results in people being stuck in lower-income professions without any benefit to public health or safety,” Hoffman said in an email.

Connection to human trafficking

State licensure’s effectiveness in rooting out the sex trade and human trafficking hiding in the massage industry will be something legislators consider as they look at the bill.

Joe Rubino, a Salina massage therapist of 19 years who’s against regulation, said human trafficking is being unfairly used as a scare tactic to get the bill passed.

But law enforcement has found instances of massage workers being transported into Kansas for the purposes of prostitution.

In 2009, two owners of massage parlors in Johnson County were sentenced to five years in federal prison for recruiting employees from China, then coercing them to engage in prostitution.

The owners, Zhong Yan Liu and Cheng Tang, recruited the women to come to the Kansas City area and obtained municipal massage licenses with the city of Overland Park for them. The women worked from 9 a.m. to 11 p.m. seven days a week, were not paid, lived at the massage parlors and, in exchange for money, performed sexual services, according to the FBI.

More than $450,000 from the prostitution business was wired to locations in China.

Last year in Topeka, federal prosecutors brought charges against two Topeka massage parlor owners for trafficking women for prostitution purposes. The two pleaded guilty and were sentenced in November.

Gov. Sam Brownback and Attorney General Derek Schmidt have been vocal about the need to reduce human trafficking in the state. They spearheaded a 2013 law that increased penalties and enforcement tools.

Ruben Salamanca, leader of the Topeka Police Department’s Narcotics Vice Unit, said his group initiated a significant anti-prostitution operation last year that revealed human trafficking.

Some massage parlors were part of the problem.

“We’ve since done operations against a vast majority of those massage parlors,” Salamanca said.

In 2014 Wichita law enforcement initiated 14 investigations and made 11 arrests for illicit massage businesses, said Jeff Weible, bureau commander for crimes against persons in Wichita.

He said law enforcement officials in Wichita are monitoring the state licensure bill and researching ways to address the issue of illicit businesses by talking with legitimate business owners.

“It’s not a matter of competition,” Weible said. “It’s a matter of people coming in, getting a massage and asking for additional services that aren’t available at legitimate businesses.”

Local vs. state regulations

Also at issue is whether standards for massage parlors should be set by the state or by local governments.

About 10 Kansas communities, including Lenexa, have local ordinances that require massage therapy licenses to do business in the city limits.

Lenexa Police Chief Thomas Hongslo told the Senate committee that Lenexa sees issues with the bill’s failure to confront fraudulent massage therapy “schools” and potential to create disjointed regulation between local governments and the state.

“The state and local authorities may have very different ideas of what should constitute a disqualifying offense,” he said. “We believe that cities should have control over these issues, which are important and sensitive to their citizens.”

Hongslo said when therapists violate the law in Lenexa, it often also affects the massage therapy business’ license, so Lenexa now can solve both issues at the local level.

Ed Klumpp, a lobbyist for three law enforcement organizations, said those groups don’t plan to get involved with the state proposal.

“If individual (police) chiefs want to go up and support it, or if individual chiefs want to go up and oppose it, they can do that,” Klumpp said.

The Senate and House committees have not taken action on the massage licensure bill.

Ashley Booker is an intern for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

EMPORIA – A Kansas woman was injured in an accident just after 11:30 p.m. on Saturday in Lyon County.

The Kansas Highway Patrol reported a 2007 Chrysler Sebring driven by Courtney R. Wylie, 20, Cottonwood Falls, was southbound on Kansas 99 two miles north of Emporia.

The vehicle left the roadway to the right, and struck a tree.

Eagle Med flew Wylie to Stormont Vail in Topeka.

The KHP reported she was properly restrained at the time of the accident.

WASHINGTON – With 29 cosponsors, Rep. Tim Huelskamp (KS-01) has reintroduced the Marriage Protection Amendment (H.J.Res 51 in the 113th Congress), a proposed constitutional amendment to affirm marriage as the union between one man and one woman for all federal and state purposes.

This spring the U.S. Supreme Court will review the 6th Circuit Court of Appeals ruling, which upholds marriage laws in MI, KY, OH, and TN. As the Court prepares to hear oral arguments, Congress must respond now to provide clear Constitutional guidance and uphold the true meaning of marriage long term.

In June 2013 the Supreme Court struck down section 3 of the federal Defense of Marriage Act (DOMA) which had defined marriage for federal purposes as the union of one man and one woman, but upheld the right and responsibility of states to define marriage. Since then though, numerous unelected lower court judges have construed the U.S. Constitution as suddenly demanding recognition of same sex “marriages,” and they struck down state Marriage Amendments — including the Kansas Marriage Amendment — approved by tens of millions of voters and their elected representatives.

“Given the current legal chaos on marriage, it’s important that we work to enact a definitive marriage policy on a national level. Defining marriage as between one man and one woman will preserve religious freedom, strengthen families, and benefit children.

“The reality is that moms and dads matter. Decades of academic research on families, combined with centuries of human experience, agree – children do best when they have a married mom and dad in the home.”

WASHINGTON (AP) — Don’t expect to see them soon, but they could be coming to your local grocery store — two types of apples genetically modified to resist turning brown after they’re bruised or sliced.

Arctic Golden and Arctic Granny Smith are being developed by a Canadian company, Specialty Fruits Inc. of Summerland, British Columbia.

The Agriculture Department gave its OK on Friday — saying the apples aren’t likely to pose a plant pest risk and or have “a significant impact on the human environment.”

The first Arctic apples are expected to be available in late 2016 in small, test-market quantities.

It takes apple trees several years to produce significant quantities, so it’ll take time before the genetically-modified apples are widely distributed.