KHI News Service

Praeger gets green light to proceed with reform

Republican opponents of the law say they must be practical about it

By Jim McLean | December 09, 2010

Insurance Commissioner Sandy Praeger said Wednesday that Governor-elect Sam Brownback and key state legislators opposed to federal health reform have signaled that it’s okay for her to continue her work to implement the law.

Praeger, a Republican, spent several hours Wednesday updating members of the Legislature’s Joint Committee on Health Policy Oversight on what her office is doing to implement the reform law and the timetables it needs to meet.

In an interview afterwards, Praeger said that Brownback, who during his election campaign vowed to continue his opposition to the reforms, has told her to continue implementing it pending the outcome of federal court challenges and efforts in Congress to repeal the law.

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Praeger moving ahead with reform law implementation

Specifically, Praeger said that Brownback wanted her to proceed with planning for a purchasing exchange. The Web-based exchange, which the state must commit to operating by January 2013 and have operational by 2014, would be the portal through which many Kansans would purchase health insurance, including many of the state’s approximately 350,000 people currently uninsured.

Those with low enough income to qualify for federal health insurance subsidies must purchase through the new state or regional exchanges, which will be operated by the federal government should states choose not to operate them.

“He doesn’t want to give up the authority to run an exchange at the state level,” Praeger said of Brownback.

A call to Brownback’s spokesperson seeking response to Praeger’s comments wasn’t immediately returned.

Praeger, a supporter of the health reform law, said it would be better if the federal government did not operate the Kansas exchange.

“If we do nothing and the law stays on the books and it’s the law of the land, then we lose out and I just think it’s important that folks understand that,” she said. “I don’t think that we want some federal agency running our state exchange and our state Medicaid program, which would happen if we didn’t do the exchange ourselves.”

Praeger said Brownback’s support of a state-operated exchange was essential to her department qualifying for a federal planning grant. That money will be available in the spring, she said.

Rep. Brenda Landwehr, R-Wichita

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Brenda Landwehr, a Wichita Republican and staunch opponent of the reform law, said allowing Praeger and other state agencies to proceed with implementation was a practical decision.

“We are caught between a rock and a hard spot,” said Landwehr, chair of the health policy oversight committee. “We cannot have our state agencies - whether it’s the insurance department or the health policy authority or whoever – to just sit and wait to see what happens. They have to operate under the premise that this is the law of the land.”

Even so, Landwehr said, she and other opponents of the federal reforms plan to continue to push proposals at the state level to encourage its repeal and replacement with “what I consider to be meaningful and real health reform.”

The six members of Congress from Kansas – all Republicans – have said they favor repeal of the law officially called the Affordable Care Act but called “Obamacare” by its opponents.

Rep. Bob Bethell, R-Alden, another key member of the committee, said he would like to see Republicans and Democrats in Congress work together to fix problems in the law rather than battle over its repeal.

Meanwhile, he said, he supports allowing Praeger and those in charge at other state agencies to move forward.

“If we want to push back and say, ‘Hey, some of this stuff is really not where we want to go,’ that’s fine to do that,” he said. “But I think we also need to make sure that if the pushback doesn’t work that we’re in a position to move ahead when the time comes.”

Sen. Laura Kelly of Topeka, ranking Senate Democrat on the committee, said the chance the law would be repealed over objections from President Obama were small and that Kansas officials should continue to keep their options open.

“Whether we like it or not, we are in a position of either implementing reform or handing it over to the federal government, and a lot of us, I think, prefer to keep that control in the state,” Kelly said. “The only way to do that is to keep moving forward toward implementation.”