Insurance Commissioner Sandy Praeger and an advocacy organization for seniors urged the governor Tuesday to veto a bill that they say could disrupt Medicare in Kansas.
House Bill 2553 would set up a health care compact between Kansas and other states that would be separate from the Affordable Care Act. Congress would have to approve the change.
Praeger said the bill could be potentially disastrous for Kansans relying on Medicare and Medicaid, because it calls for federal health care dollars to be distributed as a block grant. That means the bill would sever federal authority for these programs as well. But it does not include provisions to explain how a state takeover would work, she said.
“This is taking away authority for a federal program and giving it back to the states with really no clear plan for how it might be administered,” said Praeger, who was joined by representatives from the AARP at the Capitol.
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“To include Medicare into an attempt to make political statements about the Affordable Care Act I think is wrong,” Praeger said.
Rep. Brett Hildabrand, R-Shawnee, who introduced the bill, said in a phone call that Medicare programs would continue unchanged.
“Every program and everything that’s currently in place with health care would carry over under the Kansas system. It would take an act of the Kansas Legislature to undo something,” Hildabrand said, explaining that Medicare would continue under a state umbrella.
Praeger and others have criticized the bill for not clearly outlining how this new authority would work; they say the change could disrupt services.
Hildabrand, however, said the bill could help ensure stability for the program.
“I think it actually shores up the security of Medicare, because at the federal level Medicare has been raided to help pay for other programs,” he said. “And the way this compact law is written is that any health care money that we receive in a block grant from the federal government absolutely must be spent on health care.”
Maren Turner, a spokeswoman for the Kansas chapter of the AARP, said the organization had sent a letter to Gov. Sam Brownback calling on him to veto the bill, now on his desk, but had yet to receive a reply.
Turner said the bill was a frivolous pursuit, motivated by partisan politics rather than by what’s best for Kansans’ well being.
“Some members of the Legislature seem determined to demonstrate their disdain for the ACA. … Well, if you want to show how much you dislike the ACA or Obamacare or whatever you want to call it, this is not the way to do it. Placing the health of Kansans in jeopardy is not the way to do it,” she said.
Curtis Ellis, spokesman for Competitive Governance Action, the Houston-based organization that created the model legislation, said the bill empowers Kansas to decide what to do with Medicare and that includes making no changes at all.
“There’s nothing in the health care compact that says Kansas has to change Medicare by one comma or one semicolon,” Ellis said.
If the bill is signed by the governor, it still would need approval from Congress.
This is an election year. If Republicans keep their majority in the U.S. House and also take the U.S. Senate, partly on the strength of campaigning against the Affordable Care Act, the idea could pass in Washington just as it did in Topeka, Praeger said.
U.S. Rep. James Lankford, R-Okla., introduced legislation in February to authorize the compact. And U.S. Rep. Tim Huelskamp, R-Kan., became a co-sponsor in April.
The Constitution does not require presidential approval for interstate compacts. That’s why Brownback’s decision on the bill is so crucial, Praeger said.
“To say it might not happen, therefore let’s not worry about it, I think is misguided. Better to be safe than sorry,” Praeger said.
She noted that Republican Gov. Jan Brewer of Arizona vetoed a similar bill in Arizona in 2011 based on concerns of the potential impact on seniors.
“If I were the governor, I would want to be cautious,” Praeger said.
Eileen Hawley, the governor’s spokeswoman, said that he carefully reviews all legislation that comes across his desk. She declined to speculate on what decision he’ll make.