With less than two weeks before a major component of the Affordable Care Act goes into effect, there are still a lot of questions about how the health law will affect Kansans.
Kansas Insurance Commissioner Sandy Praeger tried to answer some of those questions at the annual Luzzati Lecture Series on Thursday night at Wichita State.
“No longer as a nation can we afford to not have a health care system that addresses everyone’s needs,” said Praeger, who has been insurance commissioner since 2002 and previously was a member of the Kansas Senate and House of Representatives.
After giving a brief history of the attempts at universal health care since the era of Teddy Roosevelt, Praeger pointed out the success of the 2006 Massachusetts health care law, which was signed by then-Gov. Mitt Romney.
While the plan has had high consumer satisfaction, she noted there have been some cost containment issues. Massachusetts has the lowest uninsured rate in the country.
“Students and the general public are under the mistaken impression that Obamacare is a government-run health insurance program that provides insurance like Medicare and Medicaid. And it’s not. It’s a government-regulated market system,” said Neal Allen, assistant professor of political science at Wichita State.
The Affordable Care Act was passed in 2010. Last year, the Supreme Court ruled that the provision requiring states to expand Medicaid was unconstitutional, so some states, like Kansas, refused to expand Medicaid despite the federal government’s offer to pay the full cost of expansion the first three years, and nearly the full cost thereafter.
“Congress never anticipated that states would turn their backs on 100 percent funding (of expanded Medicaid),” Allen said. “They’re a little perplexed.”
By not expanding Medicaid, there will be gaps in who will be able to afford health care coverage. Some will make too much money to qualify for Medicaid in Kansas, which has one of the lowest thresholds in the state, while at the same time being too poor to qualify for subsidies on the marketplace.
Praeger also noted that her office did not make the decision to not expand Medicaid.
“That was not our fault,” she said.
She’s hopeful that once the Affordable Care Act is implemented and communities see the effect of not expanding Medicaid it will put pressure on elected officials in Kansas to change policy.
“When the reality of this hits home in some of those districts across the state, I’m hoping people will start hearing from their constituents,” she said.
The federal government said that those who fall into that gap in states that do not expand Medicaid will not have to pay a penalty like everyone else if they don’t get health insurance.
“I’m hopeful,” said Democratic state Sen. Oletha Faust-Goudeau, who attended the lecture and said she’s been lobbying for Medicaid expansion. “I think as human beings we are afraid of change. It’s going to be up to the people and how they feel.”
The insurance department has created a website, www.insureks.org, to share resources regarding the Affordable Care Act. The website also includes a cost calculator for consumers who want to estimate how much of a subsidy they may qualify for on the new marketplace.
However, the actual rates and plans for the marketplace, which will be on www.HealthCare.gov, will not be released until open enrollment begins on Oct. 1.
Praeger also explained the tax credits and subsidies that are a part of the new online marketplaces and how people within the income bracket between $23,550 and $94,200 can qualify.
Those who have employer-sponsored health plans that the government deems affordable – meaning they don’t cost more than about 9 percent of a person’s income – won’t really be affected by the law. Neither will people on Medicare, Praeger said.
Kansas is among 34 states that have opted for a federally facilitated online marketplace, which means the state will not have as much control as it would have if it were state-run, Praeger said. However, she assured the audience that her office was working closely with the federal government on the options for Kansas.
For small-business owners, Praeger emphasized that the impact of the health law will be minimal. She said she disagreed with Lt. Gov. Jeff Colyer’s remarks earlier this week in Washington about how small businesses will be hurt by the new law.
If anything, she said, it will help build entrepreneurship since small business owners won’t have to worry about getting health insurance for themselves and loved ones at an affordable rate and regardless of pre-existing conditions.
“I think some small businesses have been confused by the political rhetoric that’s out there,” she said.
“This law is building on the private insurance marketplace. … This is a very conservative approach, but you wouldn’t believe that based on the rhetoric out there.”
Under the law, only employers with more than 50 employees will be required to provide affordable insurance. Those with less than 50 will not be required to provide insurance, but will still be able to purchase plans on the marketplace if they want.
“I agree with what she said about what” Colyer said, said Ben Huie, who attended the lecture and whose family owns a small business. “It’s not truthful, it’s not accurate. I’m a registered Republican, but what the Republican Party has become is strictly against anything.”
“I have to laugh at some of it because I’m very familiar with Romneycare in Massachusetts and I sometimes refer to this plan as national Romneycare. … It is rather ironic to me that what had been in fact a Republican initiative when it was started in Massachusetts is the worst thing in the world to the Republicans.”
One student who attended the event was senior political science major Valerie Brockman, who is originally from Germany. She said watching the implementation and debate in the U.S. has been interesting.
“We take it for granted. For us, in Germany and the rest of Europe, health care is a human right,” Brockman said.
Other elected officials from Wichita who attended the lecture included former Republican state Sen. Jean Schodorf and Republican Rep. Jo Ann Pottorff.