Print edition: 
Gov. Sam Brownback’s abrupt, unilateral decision Tuesday to refund the state’s $31.5 million “early innovator” health care reform grant to the federal government serves politics, specifically the Republican determination not to touch “Obamacare” with a 10-foot pole. But it certainly does nothing for Kansans’ health or the state budget.
Brownback’s refund of a grant seems to assume that the Patient Protection and Affordable Care Act is going to be ruled unconstitutional by the U.S. Supreme Court — an unsafe assumption based on the mixed bag of legal rulings to date.
And the move badly disrespects the months of hard work by Kansas Insurance Commissioner Sandy Praeger and her team to have an online insurance marketplace for the state ready to go by January 2014, with help from the federal grant. Praeger wasn’t even told about the decision until late Monday evening.
Under the federal reform law, the exchange is where consumers and businesses in each state will be able to shop for the best private health coverage for them; it also will handle people seeking Medicaid coverage.
“We want this to be run by Kansans for Kansans,” Praeger said Monday in Topeka, before Brownback’s decision.
Praeger, a Republican and a national leader in helping shape health care reform in a way that served states’ interests, had tried and failed to persuade the GOP-led Legislature to take some actions to help set up the marketplace.
But even GOP lawmakers were caught off guard by Brownback’s decision, especially given that Brownback reportedly had signed letters enabling Praeger to accept the grant.
“It was a surprise to me,” Senate President Steve Morris, R-Hugoton, told the Topeka Capital-Journal. “Having money to implement this was a good move on the federal government’s part.”
Now, instead of being among the half a dozen states on the leading edge of setting up these health insurance exchanges, Kansas will be in the situation of lagging and, eventually, trying to catch up — and paying for it with scarce state dollars rather than a federal grant.
Another frustration in Brownback’s move is that the idea of an online insurance marketplace was promoted by GOP lawmakers in Kansas and elsewhere for years. They championed it as a free-market approach to helping individuals and small businesses reduce costs through greater competition. But once it emerged as part of the federal reform, the idea suddenly became radioactive to Republicans.
The health care industry is busy getting ready for the reform law, including the online insurance exchanges. Kansas should be doing likewise, not returning federal dollars and blithely acting as if “Obamacare” will be history any day now.
