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Kansas has small window for input on health insurance exchange

But insurance commissioner says opening will close if governor stonewalls the effort

By | June 28, 2012

In the wake of today's U.S. Supreme Court ruling, Kansas could still avoid ceding total control of its health insurance exchange to the federal government if it moves quickly, Insurance Commissioner Sandy Praeger said.

“That’s probably the best-case scenario now from an exchange standpoint,” Praeger said.

But that would require a meeting of the minds between Praeger and Gov. Sam Brownback and meeting a mid-November deadline for alerting federal officials to the state's intentions.

Last year, Brownback returned a $31.5 million federal grant that would have helped the state develop its own exchange. And today, after the court's decision, the governor vowed he would do nothing to implement the Affordable Care Act's provisions until after the November elections.

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“Stopping ObamaCare is now in the hands of the American people," Brownback said. "It begins with electing a new president this fall.”

Opposition from Brownback and Republican legislative leaders resulted in Kansas missing deadlines for establishing its own exchange. Under the federal law, each state must have an operational exchange by Jan. 1, 2014, with plans for it certified by Jan. 1, 2013. States that choose not to implement an exchange on their own would cede that authority to federal officials.

Kansas missed the cutoff for developing its own exchange but could still partner with the federal government on one, an arrangement that Praeger said would allow state officials to set rules for insurance company participation in the online marketplace and direct consumer assistance efforts.

“Plan management and consumer assistance are two functions that our industry and our agent community are most concerned about. So, I think they would like us to retain control,” Praeger said.

Praeger said federal officials have told her that she doesn’t need explicit authorization from Brownback to proceed. She could sign the letter declaring the state’s intention to partner with the federal government on an exchange.

Despite those assurances, Praeger, a moderate Republican who supports the health reform law, said she doesn’t want to circumvent Brownback, a conservative Republican who continues to fight the law.

“Even if I’m allowed to sign the letter, I’m not going to do that unless the governor at least agrees they won’t try to block our efforts,” Praeger said. “After the dust settles, I think we (Praeger and Brownback) will have a conversation and we’ll sort through all of the issues.”

As outlined in the Affordable Care Act, individuals, small-business owners and people whose incomes qualify them for federal subsidies and tax credits would shop for policies using the exchange websites that would help the shoppers sort through coverage and price options. The exchange also could be used to determine eligibility for the Medicaid program, eligibility for which would be expanded under the law where states choose to do so.


Previous coverage of health reform and the Supreme Court

Anticipating the Supreme Court's ruling

Supreme Court to rule Thursday on health care reform
New consumer protections depend on high court's ruling
Court challenge could result in Medicaid cutbacks instead of expansion
GOP promises smaller-scale health care agenda if court strikes down law
Some health system changes will stay, no matter how Supreme Court rules
Obama administration finds 3.1M young adults gained coverage under law
What's at stake for Medicare beneficiaries in health reform ruling
What's at stake for women if health law overturned
Washburn law professor holding to prediction that health reform law will be upheld
Even without the individual mandate, health law would still affect millions

The Great Health Reform Debate: Kansas experts weigh in
"The system we have in this country is a failure because people do not have equal access to care," said retired Stormont-Vail HealthCare CEO Maynard Oliverius. He is one of six Kansas experts who weigh in on the health reform debate ahead of the Supreme Court's ruling on the law.
Watch the six video shorts here.

Oral arguments before the Supreme Court

Day 1 — Anti-Injunction Act
Guide to what happened at the Supreme Court
Day 2 — Individual Mandate
Kansas AG Schmidt encouraged by justices' skepticism of health reform law
Justices grill Obama administration on health law
National media round-up
Day 3 — Medicaid Expansion and Severability
Vigorous severability, Medicaid questions

Preview to the Supreme Court oral arguments

Schmidt’s pledge to join ACA challenge bolstered candidacy
Full interview: Derek Schmidt on the legal challenge of the health reform law
The Health Law and the Supreme Court: A primer for the upcoming oral arguments
Video explainer: The health care reform challenge before the Supreme Court

Related coverage

Kansas rejects $31.5 million for insurance exchange

More archived stories and in-depth information on the Affordable Care Act


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