Kansas Health Institute | Information For Policy Makers. Health for Kansans.

TOPEKA — The shockwaves emanating from Republican Scott Brown’s U.S. Senate victory in Massachusetts on Tuesday are being felt beyond the Bay state and Washington, D.C.

They’re registering in state capitals across the country, including Topeka.

Observers here and elsewhere are speculating about what Brown’s election will mean for an ambitious but controversial health reform bill that until a few days ago appeared to be on its way to passage.

“I’m discouraged but I’m not giving up hope,” said Corrie Edwards, executive director of the Kansas Health Consumer Coalition and a spokesperson for the Faith Alliance for Health Reform.

During his campaign to fill the seat held more than 40 years by the late Democratic Sen. Ted Kennedy, Brown promised to be the vote Republicans needed to block further consideration of a bill being pieced together by Democratic leaders in Congress and the White House.

What next?

Edwards and others who favor reform are clinging to the hope that either the U.S. House can pass the bill already approved by the Senate and send it to President Obama or that a smaller, but still meaningful reform bill can become law with bipartisan support.

The bills that passed the House and Senate did so in the face of staunch Republican opposition and with weak support from moderate Democrats.

University of Kansas political scientist Burdett Loomis, a nationally recognized congressional scholar, said House leaders will have a difficult time mustering the 218 votes they would need to approve the Senate bill given that the House version passed in November with only two votes to spare.

“I think it’s 50/50 at best,” Loomis said. “Every stop would have to be pulled out.”

Congressman Anthony Weiner, D-N.Y., a leading reform supporter, told U.S. News & World Report today that Democrats will need to scale back their reform plans in the wake of Brown’s victory.

“The only way forward is to take a step back,” Weiner said. “If there isn’t any recognition that we got the message and we are trying to recalibrate and do things differently, we are not only going to risk looking ignorant, but arrogant.”

State Rep. Brenda Landwehr, R-Wichita, has opposed the federal reforms. She said if Democrats push through the Senate bill it will ring a political death knell for some of their colleagues in the House.

“They would have to find enough House members that the administration is prepared to throw under the bus and then convince them to commit political suicide,” Landwehr said.

Loomis said he thought it also unlikely that Democrats and Republicans could come together to pass a meaningful compromise bill given the acrimony that exists.

“I don’t see a health care package passing,” Loomis said. “I would just be stunned. The blood is just so bad, I don’t see how the Republicans move away from their scorched earth approach.”

Restarting the debate

But Edwards said she remains hopeful a bill that prohibits insurance companies from denying coverage to persons with pre-existing conditions and from imposing annual and lifetime caps on coverage will pass. Any bill that passes should also include subsidies and tax credits to make coverage more affordable to both individuals and small businesses, she said.

Tom Bell, president of the Kansas Hospital Association, called the Massachusetts results “a reality check for the president and congressional leadership.”

Like Edwards, he said some version of the insurance reforms in the current bills could be the starting point for negotiations on a compromise acceptable to both parties.

“This gives everyone – Republicans and Democrats – the opportunity to reassess the healthcare situation and try to come together around something that is truly bipartisan in nature,” Bell said in an e-mail to KHI News Service.

Kansas Congressman Todd Tiahrt, a Wichita Republican running for the U.S. Senate seated to be vacated by Sam Brownback, said now is a good to begin again with the debate on health reform.

“And a good place to start is a live town-hall meeting on CSPAN,” he said in a prepared statement released Tuesday after the results in Massachusetts were known.

The reform plan that appeared headed for passage before the Massachusetts election would have extended health coverage to an estimated 36 million additional Americans over a decade by requiring most individuals to purchase insurance and by significantly expanding Medicaid eligibility. The plan also included subsidies and tax credits to low-income individuals and small businesses to buy health insurance

Cost not coverage

Edwards said the advocates she works with in Washington believe that many if not all of the coverage expansion initiatives would be at risk if Democratic leaders and the White House decide to compromise with Republicans.

“I think it would put some pretty vital pieces in jeopardy,” Edwards said.

But Landwehr and other opponents of the Democratic plans see that as a positive development, charging that cost not access to coverage is the most pressing issue.

“What we should be doing is talking about what is driving up the cost of health care and what we can do to change that,” she said.

A Kansas legislative subcommittee created by Landwehr is scheduled to hold three meetings on health care costs. The first is scheduled for Friday, Jan. 22 at 9:30 a.m. in room 711 of the Docking State Office Building.