KHI News Service

Insurance commissioner weighs in on health care compact bill

Says plan that would let states make the rules for Medicare and Medicaid is a bad idea

By Jim McLean | February 26, 2014

Insurance Commissioner Sandy Praeger today jumped into the political tussle over proposed legislation that would add Kansas to a list of Republican-led states that are petitioning Congress for authority to oversee Medicaid, Medicare and other health care programs now mostly controlled by the federal government.

Praeger, a Republican whose support of the Affordable Care Act has put her at odds with many in her party, issued a news release to warn consumers about the bill’s potential to “jeopardize” Medicare.

“It could jeopardize the coverage and benefits that seniors have come to count on,” Praeger said. “Kansans have paid into this program through payroll taxes and expect to receive the benefits they have been promised.”

Kansas Insurance Commissioner Sandy Praeger (left) and Kathleen Sebelius, secretary of the U.S. Dept. of Health and Human Services.

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The proposed legislation – House Bill 2533 – would authorize the state’s membership in an interstate health care commission.

If Congress were to approve the compact, which for now at least seems unlikely, member states could set their own rules for Medicare, Medicaid and other government health care programs.

Should that happen, Praeger said, she is concerned that Kansas officials could divert money from the health care programs to other initiatives or to cover projected budget shortfalls.

“It’s already happening with dollars meant for highway programs,” she said.

Supporters of the measure have cited it as a way to circumvent the Affordable Care Act, which remains unpopular in Kansas.

Rep. Steve Brunk, a Wichita Republican who chairs the House Federal and State Affairs Committee, said putting the state in control of how Medicare and Medicaid dollars are spent should not be a cause for concern.

KHI News Service

Sen. Mary Pilcher-Cook, R-Shawnee, talks with Kansas Secretary of State Kris Kobach. The pair urged a House panel to support a bill that would petition Congress to free Kansas and other states from federal health program regulations.

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“All it does is put a mechanism in place for a future Legislature to determine our own health care fate,” he said after holding a hearing on the proposal in his committee. “It’s about sovereignty, it would allow us to extricate from any federal system or keep any federal system. It would let us pick and choose what is the best mechanism for Kansas.”

Sen. Mary Pilcher-Cook, a Shawnee Republican who chairs the Senate Public Health and Welfare Committee, and Republican Secretary of State Kris Kobach have been leading supporters of the bill, which failed to advance when introduced in earlier sessions.

The federal government pays all Medicare costs and not quite 60 percent of Medicaid, leaving Kansas taxpayers to cover the remainder of the cost for the program that covers approximately 400,000 low-income and disabled Kansans as well as seniors in need of nursing home care who have exhausted their personal resources.

About 448,000 Kansans 65 and older are covered by Medicare.

Praeger acknowledged Congressional approval of the compact is unlikely as long as Democrats control the U.S. Senate. But she said it could become less of a long-shot if Republicans gain full control of Congress in this year’s elections.

“I just don’t want to take any chances,” she said. “I don’t see it as a real threat but goodness knows there have been some strange things that have happened. And I don’t want to be sorry I didn’t speak up.”

Eight states have approved compact laws. Kansas is one of 12 others known to be considering similar proposals based on model legislation promoted by the American Legislative Exchange Council, or ALEC.

The nonprofit advocacy organization includes state legislators from across the country – mostly conservative Republicans - and is supported by several large businesses, including Wichita-based Koch Industries.

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