Kansas Gov. Sam Brownback said he wants to wait until after the presidential election to comply with a key provision of the federal health care overhaul upheld by the U.S. Supreme Court, but the state’s Republican insurance commissioner objected.
Brownback, also a Republican, told reporters that putting the 2010 health care law into effect in Kansas and other states is a political issue to be resolved by voters in November.
“If the American people don’t want Obamacare, it’s a political issue, and it’s about this fall presidential race, whether or not you want to implement it,” Brownback said. “I want to see what happens in the fall.”
Brownback said that if GOP presidential nominee Mitt Romney unseats Democratic President Barack Obama, who championed the law, states are no longer likely to face a requirement to set up exchanges to help consumers buy health insurance. Exchanges would be online marketplaces for health insurance, allowing consumers to comparison shop, and are sometimes described as the health coverage equivalent of websites such as Travelocity.
The federal law requires each state to operate an exchange by 2014, and plans must be submitted by Nov. 16 to the U.S. Department of Health and Human Services. Kansas hasn’t started to set one up because Brownback and Republicans who control the Legislature oppose the entire law.
Insurance Commissioner Sandy Praeger said the state has an obligation to move forward now that the law has been upheld. She said the state still has a chance to have some say in how an insurance exchange is run in Kansas — power it’s likely to forfeit if it delays decisions.
“I think there is still a belief that somehow if we have a new administration, that this potentially could all go away,” Praeger said during a news conference. “What’s the harm in preparing for the eventuality that things don’t change? I think Kansans are still better off if we try to keep all of our options open.”
Praeger said it’s too late for Kansas to develop its own exchange, but it still could seek a partnership with the federal government or have the federal government run the exchange. She said that would allow Kansas to determine which companies can sell coverage and to handle consumer complaints.
Kansas has about 350,000 residents who don’t have health insurance coverage, or 12.7 percent of the state’s population, according to U.S. Census Bureau figures. About 53,000 are children.
Last year, Brownback returned a $31.5 million federal grant to assist the state with the computer infrastructure for an exchange. Praeger acknowledged that even if the state had kept the money, legislative opposition probably would have kept work on an exchange from moving forward.
The Supreme Court decision is likely to frustrate and anger many Kansas Republicans. Freshman U.S. Rep. Tim Huelskamp, a GOP conservative, promised to work for the law’s repeal and called “a definitive date in the advance of government tyranny.” Other members of the state’s all-Republican delegation in Congress promised to work to repeal the law.
Brownback said if Romney is elected, states are likely to get a blanket waiver from the requirement to have exchanges.
But Praeger said: “I’d rather keep our options open than put all my eggs in the basket of repeal and replace.”
And Kansas House Insurance Committee Chairman Clark Shultz, a Lindsborg Republican, said state officials ought to at least discuss what options Kansas has should an exchange be required.
“It seems that we should at least have something in mind on how we go forward if we need to,” Shultz said.
Kansas House Minority Leader Paul Davis, a Lawrence Democrat, predicted that even if Romney is elected, he’ll have to consider creating exchanges as part of any plan for reforming the health care system.
“He is going to have to deal with the rising cost of health care and the limited options that consumers have in the marketplace,” Davis said. “I have really yet to hear the governor or anybody in the Republican Party articulate what the problem with a health insurance exchange is. Until they do that, we’re not having much of a meaningful dialogue here.”