Lt. Gov. Jeff Colyer testified to Congress Wednesday that Kansas is having and expecting more trouble implementing the Affordable Care Act, although the state has opted not to participate in the national health plan to the extent possible.
Colyer, a physician, told congressional subcommittee members that he thinks uncertainty over implementation of the act – better known as Obamacare – is harming business.
He said he’s heard numerous complaints about the law from state residents and likened the act to “ice on the wing of an airplane preventing it from taking off.”
Colyer cited a Kansas businessman who recently testified to Congress that he was unwilling to grow his business beyond its current 44 full-time employees because going over 50 would mean he would have to comply with the ACA requirement to offer health-care plans to his employees.
“Businesses are scared to invest in jobs, they’re scared to invest in expansion, and they’re scared to invest in Kansas’ future,” Colyer said in his written testimony. “This is damaging to everyone, but felt most directly by the middle class.”
In his direct testimony, Colyer criticized the federal insurance exchange, also known as a marketplace, where uninsured Kansans will be able to shop for insurance, and if eligible obtain subsidized coverage, when that aspect of the ACA takes effect Oct. 1.
“In the state of Kansas, our exchange is only going to have two insurers on the entire exchange,” Colyer said. “Two insurers. That is not more competition, that’s less competition.”
Democrats disputed Colyer’s remarks, saying Republican resistance to the ACA is causing problems, not the law itself.
“All this screaming ‘I don’t like Obamacare because the president passed it’ doesn’t really help in the conversation,” said state Rep. Jim Ward, D-Wichita, and the ranking Democrat on the House Health and Human Services Committee.
He said Gov. Sam Brownback and Colyer, his chief adviser on health issues, are quick to complain about the ACA but “don’t provide any meaningful solutions to the issues most people talk about, which is cost and availability.”
Ward said he agreed with Colyer as far as that health care costs are causing problems for business. “I disagree that the Affordable Care Act is the critical component” of those costs, he said.
Under the Brownback administration, Kansas opted not to create a state-run exchange to encourage health care competition, leaving implementation of that aspect of the plan to the federal government.
The administration also has passed up federal funding to expand Medicaid as part of the ACA. That leaves a gap of uninsured people whose income will be too high to qualify for Medicaid, but too low to qualify for subsidized coverage through the ACA-created insurance exchanges.
Colyer also told the representatives that the ACA recently cost his own medical practice $3,400 because he had to have his business’ compliance manuals rewritten to comply with the new law.
“I’m a sole practitioner. Just yesterday, we had to sign a contract for $3,400 to rewrite all of our compliance manuals to fit in with the ACA,” he said. “All it does is continue the same HIPAA (Health Insurance Portability and Accountability Act) requirements we had before, but we just have to have a new form of documentation.”
Colyer was one of seven state officials to testify before the House subcommittee on Economic Growth, Job Creation and Regulatory Affairs, and the subcommittee on Energy Policy, Health Care and Entitlements.
Four including Colyer opposed the ACA; three of the panelists supported it.
The hearing was one of many that have been held in the House, where Republicans control the agenda and have voted more than 40 times to repeal Obamacare, despite near-certainty that such a measure won’t pass the Democratic-controlled Senate and absolute certainty the president would immediately veto it if it did.
In response to questioning by Rep. James Lankford, R-Okla., Colyer said the state is working out its own solutions to health care, such as the privatization of Medicaid service through its KanCare managed-care program.
“We’ve gone through and overhauled our entire Medicaid system. We did not throw anyone off our system, we did not cut rates, but we were able to save a billion dollars by competing it out,” he said. “And everybody now has three choices where they didn’t have any choices before.”
“So there are state solutions you’re proposing on this?” Lankford asked.
“Absolutely,” Colyer replied.
Ward, however, said the only place to achieve savings in the KanCare system will come from delaying payments to providers and declining claims for people who are covered.
“I think there should be a state solution, but it shouldn’t be on the back of denying coverage,” he said.