The Kansas House tied itself in knots today over a bill to allow insurance companies to market “mandate lite” health insurance policies in the state.
Members voted in the morning to reject the bill but abruptly reversed themselves in the afternoon. The whole thing took hours of debate. The measure, part of a legislative package included in a conference committee report, passed the Senate on Thursday. It now goes to Gov. Sam Brownback.
Before it was added to the conference committee package, the mandate measure — Senate Bill 163 — passed the Senate 38-1 on Feb. 20. It was endorsed by the House Committee on Insurance but was never debated by the full House until today.
Rep. Jim Ward, a Wichita Democrat, objected to that. He said a conference committee report requiring legislators to vote on several measures at once was the wrong way to make major policy decisions. He moved to send the entire package back to conference with instructions to remove the mandate-lite bill.
“If you think the idea of no-insurance insurance is good then they will bring it to this floor, we will have a debate, we will have amendments and it will get an up-or-down vote based on its merit, not on a sneaky plan in a conference committee report,” Ward said urging support for his motion.
Several members argued against Ward’s motion, saying that the bill would simply give a choice to consumers who otherwise might not be able to afford health insurance.
Rep. Virgil Peck, a Tyro Republican, urged members to defeat Ward’s motion, arguing that mandate-lite policies would be cheaper than full-coverage and would give many consumers a choice between “something instead of nothing.”
Currently, Kansas law contains dozens of coverage mandates. Benefit mandates include immunizations, mammograms, prostate screening, diabetes care, maternity stays and substance abuse treatment. State law also includes provider mandates, which require health insurance policies to cover services provided by optometrists, dentists, chiropractors, podiatrists, psychologists, social workers, pharmacists and advanced registered nurse practitioners.
The mandate-lite bill would remove all but three provider mandates — those for optometrists, dentists and podiatrists. And it would remove all the benefit mandates except the one requiring policies to cover reconstructive breast surgery.
Motions to reject conference committee reports made by members of the minority party —particularly those offered late in the legislative session — rarely succeed. But Ward’s motion passed on a bipartisan vote, 68-51.
By the time the House reconvened for its afternoon session a few hours later, things had changed. Members quickly voted 67-50 to reconsider their earlier action. That resurrected the conference committee report and set the stage for another vote.
Supporters of the bill pressed their case, reiterating that it would provide consumers with cheaper health insurance options.
“It’s really about giving people choice,” said Rep. Dan Hawkins, a Wichita Republican and owner of an insurance agency.
Supporters were briefly put on the defensive when Rep. Phil Hermanson, a Wichita Republican and vice-chairman of the insurance committee, couldn’t answer questions about whether the mandate-lite bill complied with coverage requirements in the federal Affordable Care Act.
“It’s quite a few pages,” Hermanson said of the federal health reform law. “I haven’t had a chance to get through it. At this point, I couldn’t dissect everything that’s covered or not covered.”
Several Democrats and moderate Republicans urged members to once again send the bill back to conference committee.
Rep. Don Hill, an Emporia Republican and pharmacist, criticized supporters for making the debate on the mandate-lite bill a referendum on the federal reform law.
“Mandate-lite is so close to being worthless, I think it’s a cruel hoax that we hold out any great prospect that we’re doing folks a great service,” Hill said, comparing the kind of policies authorized by the bill to pharmacy discount cards, which he also said were worthless.
But when the vote was taken, members approved the bill 69-50.
Trumped by reform law
The mandate-lite bill likely will not meet the coverage standards required by the ACA, according to Linda Sheppard, director of the Kansas Insurance Department Division of Accident and Health.
“If you’re an insurer and you’re trying to sell a plan that doesn’t have those benefits, it means you’re selling a plan that doesn’t fulfill the requirements of the law,” Sheppard said in an interview with the KHI News Service when the bill was being considered by the Senate Public Health and Welfare Committee.
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