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Originally published June 28, 2012 at 5:34 p.m., updated June 29, 2012 at 10:42 a.m.
TOPEKA In the wake of today's U.S. Supreme Court ruling, Kansas could still avoid ceding total control of its health insurance exchange to the federal government if it moves quickly, Insurance Commissioner Sandy Praeger said.
“That’s probably the best-case scenario now from an exchange standpoint,” Praeger said.
But that would require a meeting of the minds between Praeger and Gov. Sam Brownback and meeting a mid-November deadline for alerting federal officials to the state's intentions.
Last year, Brownback returned a $31.5 million federal grant that would have helped the state develop its own exchange. And today, after the court's decision, the governor vowed he would do nothing to implement the Affordable Care Act's provisions until after the November elections.
“Stopping ObamaCare is now in the hands of the American people," Brownback said. "It begins with electing a new president this fall.”
Opposition from Brownback and Republican legislative leaders resulted in Kansas missing deadlines for establishing its own exchange. Under the federal law, each state must have an operational exchange by Jan. 1, 2014, with plans for it certified by Jan. 1, 2013. States that choose not to implement an exchange on their own would cede that authority to federal officials.
Kansas missed the cutoff for developing its own exchange but could still partner with the federal government on one, an arrangement that Praeger said would allow state officials to set rules for insurance company participation in the online marketplace and direct consumer assistance efforts.
“Plan management and consumer assistance are two functions that our industry and our agent community are most concerned about. So, I think they would like us to retain control,” Praeger said.
Praeger said federal officials have told her that she doesn’t need explicit authorization from Brownback to proceed. She could sign the letter declaring the state’s intention to partner with the federal government on an exchange.
Despite those assurances, Praeger, a moderate Republican who supports the health reform law, said she doesn’t want to circumvent Brownback, a conservative Republican who continues to fight the law.
“Even if I’m allowed to sign the letter, I’m not going to do that unless the governor at least agrees they won’t try to block our efforts,” Praeger said. “After the dust settles, I think we (Praeger and Brownback) will have a conversation and we’ll sort through all of the issues.”
As outlined in the Affordable Care Act, individuals, small-business owners and people whose incomes qualify them for federal subsidies and tax credits would shop for policies using the exchange websites that would help the shoppers sort through coverage and price options. The exchange also could be used to determine eligibility for the Medicaid program, eligibility for which would be expanded under the law where states choose to do so.
Anticipating the Supreme Court's ruling
→ Supreme Court to rule Thursday on health care reform
→ New consumer protections depend on high court's ruling
→ Court challenge could result in Medicaid cutbacks instead of expansion
→ GOP promises smaller-scale health care agenda if court strikes down law
→ Some health system changes will stay, no matter how Supreme Court rules
→ Obama administration finds 3.1M young adults gained coverage under law
→ What's at stake for Medicare beneficiaries in health reform ruling
→ What's at stake for women if health law overturned
→ Washburn law professor holding to prediction that health reform law will be upheld
→ Even without the individual mandate, health law would still affect millions
The Great Health Reform Debate: Kansas experts weigh in
"The system we have in this country is a failure because people do not have equal access to care," said retired Stormont-Vail HealthCare CEO Maynard Oliverius. He is one of six Kansas experts who weigh in on the health reform debate ahead of the Supreme Court's ruling on the law.
→ Watch the six video shorts here.
Oral arguments before the Supreme Court
Day 1 — Anti-Injunction Act
→ Guide to what happened at the Supreme Court
Day 2 — Individual Mandate
→ Kansas AG Schmidt encouraged by justices' skepticism of health reform law
→ Justices grill Obama administration on health law
→ National media round-up
Day 3 — Medicaid Expansion and Severability
→ Vigorous severability, Medicaid questions
Preview to the Supreme Court oral arguments
→ Schmidt’s pledge to join ACA challenge bolstered candidacy
→ Full interview: Derek Schmidt on the legal challenge of the health reform law
→ The Health Law and the Supreme Court: A primer for the upcoming oral arguments
→ Video explainer: The health care reform challenge before the Supreme Court
→ Kansas rejects $31.5 million for insurance exchange
→ More archived stories and in-depth information on the Affordable Care Act
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.