Topeka ? Gov. Kathleen Sebelius crammed a whole laundry list of initiatives into a 25-minute State of the State address, but she received the most attention over what seemed a we’ll-go-to-the-moon moment, a call for universal health coverage.

Yet, as much as the idea may have stirred some legislators and other Kansans listening, Sebelius isn’t the first governor to make universal coverage a goal. Even in Kansas, the idea is more than a decade old.

Sebelius also didn’t back up her words with specifics. Kansans were left with declarations that universal coverage is an important goal and that this is the year to discuss a plan for eventually bringing it to the Sunflower State.

“It’s bold to call for universal health care, but it’s much easier to call for it than to accomplish it,” said Senate Majority Leader Derek Schmidt, R-Independence.

Sebelius opened her second term with an inaugural address calling for a “new politics of true empowerment,” in which all Kansans have an opportunity to fulfill their potential.

Call for coverage

In her state of the State address, she said Kansans believe “when one of us suffers, we all suffer.” She said prosperity seems unreachable to families struggling with health care costs and “it’s here where our duty to our neighbors is greatest.”

“We must commit ourselves to the goal that all Kansans will have health insurance, and we must begin now,” she said.

Much of the rest of Sebelius’ legislative agenda, including tax cuts for businesses, energy policy goals and increased higher education spending, followed a relatively safe strategy that’s worked well for her. While appealing to her base in the Democratic Party, she’s also reached out to business leaders and moderate Republicans.

“Universal health care is still the kind of issue where just calling for it gets you attention,” said Bob Beatty, a Washburn University political scientist.

To be sure, trying to start a discussion on universal health coverage carries some political risk for the newly re-elected Democratic governor.

The House’s conservative GOP leaders already have said they think the idea is misguided and that they’d rather focus on smaller initiatives such as making sure workers can carry health insurance from job to job.

It’s no mystery why conservatives dislike the idea of universal health coverage. They loathe the potential for a sweeping government mandate on individuals and employers or, as an alternative, a permanent expansion of government itself.

“I think she’s off track,” said Rep. Brenda Landwehr, R-Wichita, chairwoman of the House Health and Human Services Committee.

“Health care, all right, a good issue – but let’s empower the people and not government.”

Not so bold

However, there are reasons why Sebelius’ call isn’t so bold.

First, Sebelius said herself in her address that the idea enjoys bipartisan and public support.

Massachusetts imposed a health insurance mandate last year during the tenure of Republican Gov. Mitt Romney, and in California, GOP Gov. Arnold Schwarzenegger proposed a mandate two days before Sebelius issued her call.

Sebelius’ call didn’t blindside anyone who’s closely followed her tenure as governor or her re-election campaign. She’s never hid the fact that an initiative she first pressed last year, to make sure all children ages 5 and younger have health insurance, is a step toward universal coverage.

Been there

And someone did draft a plan to bring universal coverage to Kansas – in 1993.

“Access to a basic standard of health care is a fundamental right, and barriers which produce inequities in access to such care should be eliminated,” the Kansas Commission on the Future of Health Care said, outlining its goals in a January 1994 report. “All citizens should be assured access to a basic level of health care services.”

The Legislature created the 11-member commission in 1991, and it spent more than two years working on a plan.

Its proposal would have created a state agency through which Kansans would have been covered, eliminating insurance companies and their agents from the mix.

The commission acknowledged the possibility of massive tax increases to pay for it. One scenario was for a $1.8 billion increase in individual income taxes and another, for $1.6 billion in payroll taxes for employers. However, such taxes would have been offset by what individuals and employers no longer paid in premiums.

The proposal was bold enough to be doomed almost from the start, caught up in President Clinton’s failures on the issue and the political troubles that allowed Republicans to capture control of Congress in 1994. The Kansas commission also faced a conservative resurgence in state politics under way even before it released its report.

A plan?

This year, Sebelius simply asked legislators to consult with the 18-month-old Kansas Health Policy Authority on a plan. The $12.4 billion budget she outlined last week did renew her proposal to cover all young children but didn’t offer any other tentative steps toward universal coverage.

“I don’t mean to be too critical – we don’t have magic answers, either – but it might have been more helpful if there had been some concrete proposals to get us there,” Schmidt said.