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

TOPEKA — The House Appropriations Committee has voted to block Kansas Insurance Commissioner Sandy Praeger from spending any more federal grant dollars to plan for the implementation of the federal health reform law.

The committee members on Wednesday agreed to a budget proviso that would prohibit Praeger from spending what is left of three Accountable Care Act planning and implementation grants awarded last year to Kansas by the U.S. Department of Health and Human Services. The grants, which totaled about $2.3 million, were intended to help Kansas plan and develop a health insurance purchasing exchange and to educate consumers about the exchange.

Praeger is a former Republican legislator from Lawrence serving her third term as insurance commissioner.

The department was on course to spend about $1.9 million in grant funds in the current budget year, which began July 1, 2011. But to date, it has spent or encumbered only about $1.1 million. The proviso would prohibit the department from spending the remaining $800,000.

Rep. Trent LeDoux, R-Holton, authored the clause. He said a large majority of constituents who responded to a recent survey he sent out said they opposed both the health reform law and the state spending any more money to implement it before the U.S. Supreme Court rules on its constitutionality.

“That’s just around the corner, June or something like that,” LeDoux said of the decision. “And I think it is unwise for the state to be spending taxpayer money to implement something that may or may not be constitutional.”

The committee's ranking Democrat made a motion to allow the spending, which was included in the budget plan offered to the Legislature last month by Gov. Sam Brownback. But that motion resulted in a tie vote that was broken by the panel’s chairman, Rep. Marc Rhoades, a Newton Republican.

The proviso also would bar the insurance department from spending any of the grant money in the coming budget year even though the health reform law may have been upheld by the time the new fiscal year starts in July.

Bob Hanson, a spokesman for the insurance department, said the agency was “evaluating the committee’s decision” and would monitor the bill’s “path through the legislative process.”

The budget bill still needs to go to the full House and Senate.

Sen. Kelly Kultala, a Kansas City Democrat, said it was unlikely that the Senate version of the budget would include a similar spending prohibition.

“Based on the make-up of the Senate Ways and Means Committee and the priorities that I’ve seen us address over the last four years, I do not see us supporting the House position on this issue,” Kultala said. “I believe that we think that Commissioner Praeger is more than capable as an elected official herself to determine the best way to use that grant money.”

Kultala is a member of the Ways and Means Committee.

Republicans control both the Senate Ways and Means and House Appropriations Committees. But moderates are in charge in the Senate and conservatives dominate in the House, a dynamic that often leads to showdowns over budget and other issues.

Praeger has warned that Kansas will be unable to implement key parts of the health reform law on schedule, if it suspends all planning and implementation activities until after the constitutional issue has been settled by the high court. Among other things, she told legislators in December, any opportunity that Kansas has to create its own insurance purchasing exchange will pass, ensuring that it will be run by the federal government, should the law stand.

“The clock is ticking,” Praeger said then. “Obviously, the longer we wait the more likely it will be a federal exchange.”

The web-based exchange would be where hundreds of thousands of Kansans would shop for private health insurance and qualify for federal tax credits and subsidies to help them purchase coverage. It also would be used to determine who was eligible for an expanded Medicaid program.

The research and policy side of the Kansas Health Institute received a portion of the grant money referred to in this story to conduct and analyze a survey for the Department of Insurance.