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Health compact bill resurfaces in Kansas House committee

Secretary of State Kobach wants Congress to let states write the rules for Medicare and Medicaid

By Dave Ranney | February 18, 2014

Secretary of State Kris Kobach today urged members of a Kansas House panel to approve a measure petitioning Congress to continue federal funding for Medicaid, Medicare and other government health care programs in Kansas while letting state officials write the rules for how the money is spent and the programs are administered.

Even supporters said Congress would be unlikely to grant such a request, at least so long as Democrats hold a majority in the U.S. Senate.

Kobach is a Republican.

Also testifying in support of House Bill 2553, was State Sen. Mary Pilcher-Cook, chair of the Senate Public Health and Welfare Committee. Pilcher-Cook is a Shawnee Republican.


HB 2553

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“This legislation would give Kansas citizens the liberty to control their own health care and would allow the state to manage Medicaid funds in a way that would best help our vulnerable citizens,” Pilcher-Cook said.

Writing the rules

The bill would have Kansas officials ask Congress to approve an interstate advisory health care commission that would include Kansas and other states that want to join it. Decisions by the body would be non-binding on the member states, which would each set their own rules and regulations for Medicaid, Medicare and other government health care programs. The federal government pays for all Medicare services and not quite 60 percent of Medicaid with Kansas taxpayers footing the rest.

There are about 400,000 Kansas Medicaid beneficiaries and about 448,000 Medicare beneficiaries. Together the two programs cost about $7.2 billion a year. States currently have the option of withdrawing from the Medicaid program but would lose the federal aid should they choose that.

“How would we like to reshape the way that Medicaid or Medicare funds are dispersed?” Kobach said. “Do we think we can do a better job of controlling fraud than the federal government can? I think, probably, we could. I think most state regulation is superior to federal regulation.”

Kobach said eight states already have passed bills in support of a health care compact: Alabama, Georgia, Indiana, Oklahoma, Missouri, South Carolina, Utah, and Texas.

Kansas is one of 12 states known to be considering compact legislation.

Sen. Mary Pilcher-Cook, R-Shawnee.

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Too soon to say

Kobach and Pilcher-Cook said it was too early to say how legislators might alter the state’s Medicare or Medicaid programs, should they gain authority to rewrite the rules.

Rep. Valdenia Winn, a Democrat from Kansas City, said she wasn’t sure the Kansas Legislature would be more responsive to Kansans' needs than the federal government.

“Just yesterday, there was a rally at the Statehouse where my constituents were telling me that we need to expand Medicaid,” Winn said. “And yet we as a Legislature remain silent on this issue. I don’t see how that’s best serving the needs of Kansas citizens.

“You’ve not proven to me that this Legislature would be more responsive than the federal government,” Winn said.

Pilcher-Cook said the health care programs would be less bureaucratic and more efficient if the state ran them.

Eric Stafford, senior director of governmental affairs at the Kansas Chamber of Commerce, submitted written testimony in support of the bill.

The bill is based on model legislation promoted by the American Legislative Exchange Council after the 2010 passage of the Affordable Care Act, more commonly known as Obamacare. ALEC is a nonprofit, pro-business organization that includes state legislators – mostly conservative Republicans – and businesses as members.

The same bill or one very similar was approved by the Kansas House in the 2012 session, 86-37, but later died in a Senate committee.

Rep. Steve Brunk, R-Wichita.

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'Pig in a poke'

Dave Wilson, a past volunteer president with AARP Kansas, called the proposal “frivolous,” “scary,” and “a pig in a poke.”

Most Kansas seniors, he said, would shudder at the thought of the state taking over Medicare.

“I can tell you that the one thing I heard over and over when I was (AARP Kansas) president was, ‘Don’t let the politicians mess with Social Security and Medicare,” Wilson said. “AARP will lobby against this bill in Washington and in Topeka.”

Rep. Steve Brunk, the Wichita Republican who chairs the House Federal and State Affairs Committee, said he thought the bill would gain approval of his committee and then pass the House.

“It’s changes are good,” he said. “It’s kind of a neutral bill, actually. All it does is put a mechanism in place for a future Legislature to determine our own health care fate. 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 it the best mechanism for Kansas.”

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