KHI News Service

Passing exchange legislation will be a challenge, former speaker says

By Dave Ranney | May 19, 2011

Linda Sheppard of the Kansas Insurance Department.

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In a few months, the Kansas Insurance Department is expected to release a blueprint for how a health insurance exchange might work.

“We still have a lot of work to do but, so far, the process has been going really, really well,” said Linda Sheppard, head of the insurance department’s accident and health division.

The exchange will be an online tool similar to Travelocity through which tens of thousands of Kansans, many who are now uninsured, will purchase private health insurance, qualify for federal subsidies or for an expanded Medicaid program. Setting it up will likely require several tweaks to Kansas law and the merging of complex information systems, including those used to administer Medicaid.

Whether the proposed framework — whatever it may be — will have enough support to survive the state’s legislative process remains to be seen.

Doug Mays, a former Speaker of the House who is working to help craft the legislation and to help educate lawmakers about it, is hedging his bets.

“It will not be an easy sell, no matter what it looks like,” he said.

Mays, now a lobbyist with a client list that includes Coventry Health Care of Kansas, one of the state's largest health insurers, is leading a 20-member subgroup helping to piece together the legislative package.

The subgroup is attached to a larger working group, one of the eight that the Kansas Insurance Department has studying issues related to the exchange.

“The process for putting together an exchange is extremely complicated,” Mays said. “Whenever it comes together, there are going to be so many moving parts, it’s going to be something that no one in this state has ever seen before.

“It’s not going to be something you can drop on legislators’ desks on Day One of the (2012) session and have it pass,” he said. “It’ll be too controversial and too complicated. A lot of education is going to have to take place between whenever the proposal comes out the start of the session.

“I don’t know that there will be enough time given the fact that we’ll be starting from zero,” Mays said.

Among other things, several members of the Republican majorities in both houses and Gov. Sam Brownback remain opposed to the Affordable Care Act, which requires states to set up exchanges or risk the federal government doing it for them.

The coming legislative proposal’s chances for passage would improve, Mays said, if more legislators were involved in the working groups.

Currently, the groups include one legislator: Rep. Brenda Landwehr, R-Wichita.

Landwehr, one of the more outspoken opponents of the federal health reform law, recently agreed to chair the working group charged with figuring out how to put public and private-market health insurance products under a single umbrella.

Soon, Sheppard said, the insurance department will be inviting other legislators to join one of the work groups or to sit in on their meetings.

“We reached out to them back in late January when the planning process was just getting started,” Sheppard said. “But the scheduling conflicts were significant. There were other things going on, obviously.”

This year’s legislative session began Jan. 11; ended on May 13.

Plans also call for department officials to brief legislators over the summer and fall and host a series of town hall meetings on how the proposed exchange would work.

“We know we have a lot of work ahead of us,” Sheppard said.