Will Kansas get grant?

A letter and executive reorganization order by Gov. Sam Brownback potentially jeopardized a $31 million federal grant — though Kansans can hope the U.S. Department of Health and Human Services will overlook the missteps and approve the funding.

HHS is expected to announce today which states will receive grants to help cover the cost of creating exchanges where individuals and companies can compare and purchase insurance. Kansas had been considered a shoo-in to receive a grant — that is until Brownback signed off on an “or else” letter to HHS Secretary Kathleen Sebelius, the Kansas Health Institute News Service reported.

The Feb. 7 letter from 21 GOP governors demanded that HHS give states flexibility in operating the insurance exchanges and choosing benefit rules. The governors said that if HHS didn’t agree to their request, their states would leave it to HHS to implement and run its own exchange.

This ultimatum was a surprise to other Kansas leaders, who weren’t consulted about the letter.

Kansas Insurance Commissioner Sandy Praeger, who has been working on the exchange and submitted the grant application, said last month that “our new administration, as well as the Legislature, agrees that Kansas wants to run its own exchange.”

In fact, the grant application was endorsed by the Legislature’s Health Policy Oversight Committee and received an unofficial nod by Brownback when he was preparing to take office, KHI reported. GOP lawmakers have advocated for a state insurance exchange for years, long before it became part of the federal health care law.

Senate President Steve Morris, R-Hugoton, didn’t know anything about the letter and expressed concern about Kansas possibly giving up control of the exchange.

“I think the states always do things better than the federal government,” he said.

The grant application was also potentially undermined by a recent reorganization order from Brownback that folded the Kansas Health Policy Authority into the Kansas Department of Health and Environment. Within that ERO was a directive stating that anything any Kansas agency was doing that involves implementing the health care law also would be transferred to KDHE — which presumably includes the work being done by Praeger.

Praeger and the governor’s staff scrambled last week to prepare and send a letter to HHS explaining that she would oversee the grant, regardless of the ERO.

States already have a lot of flexibility in implementing the exchanges, so most of the governors’ demands are “moot,” Praeger said. And a commentary by Sebelius in Sunday’s Opinion pages explained that the health care law “gives states most of the resources and flexibility they’re asking for.”

As a result, HHS still might award Kansas the grant. At least we hope it will.

Praeger suggested that Brownback’s signing the letter and issuing the reorganization order were the sort of things you might expect from a newly formed administration.

When asked about the letter, a Brownback spokeswoman told KHI that “Kansans should be the ones making their health care decisions, not Washington.” But that’s the concern. Brownback’s unilateral actions potentially cost Kansas that chance.