Archive for Tuesday, December 14, 2010

Statehouse Live: Proposal seeking to halt health insurance requirement will be debated again in 2011 Kansas Legislature session

December 14, 2010, 10:26 a.m. Updated December 14, 2010, 4:57 p.m.


— Kansas officials are preparing for the federal health care reform law while at the same time state leaders are fighting it tooth and nail.

On Tuesday, Kansas Insurance Commissioner Sandy Praeger and Kansas Health Policy Authority Executive Director Andrew Allison said the state was taking the necessary organizational steps to position itself for expansion of coverage under the new law.

“We are doing everything we have to do to stay on track,” Praeger said.

Currently, there are about 340,000 Kansans without health insurance.

Meanwhile, Praeger’s Republican colleagues are trying to derail President Barack Obama’s signature piece of legislation.

A key state legislator said she will renew efforts to pass a measure aimed at blocking the federal requirement that Kansans buy health insurance.

Rep. Brenda Landwehr, R-Wichita, chair of the House Health and Human Services Committee, said she planned to reintroduce the measure when the Legislature convenes its 2011 session next month.

During the 2010 legislative session, Landwehr pushed for passage of the Kansas Health Care Freedom Amendment, which would have amended the Kansas Constitution to prohibit the state from requiring any individual or business to buy health insurance. The Patient Protection and Affordable Care Act has a section that requires most Americans to have health care insurance, starting in 2014, or pay a penalty assessed on their federal income taxes. The requirement is a key part of the legislation and is being battled in court.

Landwehr’s measure failed earlier this year to get the votes necessary to put it on the ballot. Proposed constitutional amendments require a two-thirds margin in the House and Senate before they can be placed before voters. Republicans, however, will have a much larger majority next session in the House, 92-33 over Democrats, up from 79-46.

Landwehr also said she was exploring the possibility of making the proposal simply a change in state law, which would require simple majorities in the House and Senate, and the signature of the governor.

Gov.-elect Sam Brownback, a Republican who takes office Jan. 10, has been a vocal opponent of the federal health reform law and has joined a legal challenge to the law. And Attorney General-elect Derek Schmidt, a Republican, said he would file a legal challenge to the reform, describing it as an “unprecedented power grab” by the federal government.

Rep. Jim Ward, D-Wichita, and a member of the Kansas House Health and Human Services Committee, said it will be difficult to stop passage of the health care freedom proposal, but he argued the insurance requirement is reasonable.

It was put into the bill to prevent insurance premiums “from going through the roof,” Ward said. If the requirement is removed, he asked, “How do we control premiums? How do we get these people showing up at emergency rooms without coverage to pay their fair share and be responsible? It’s a good debate to have.”

Cathy Harding, executive director of the Kansas Association for the Medically Underserved, whose membership includes 39 health safety-net clinics, said she believes state officials are moving forward based on what the current law says.

“If things change, we’ll adjust,” Harding said.

She said most major pieces of legislation are altered as conditions change. “Everyone expects the law to change. How much, no one knows,” she said.

On Monday, a federal judge in Virginia ruled that the federal requirement to have insurance was unconstitutional. Two other judges, however, have upheld the law.

Insurance Commissioner Praeger said, “This is going to be decided way down the line and probably at the U.S. Supreme Court.”


kuhusker 7 years, 6 months ago

What a waste of time. This issue will be decided by the federal courts. If they rule against the health care law, then it's history. If they rule in favor of it, then there's nothing Kansas can do, because of the Supremacy clause of the US constitution.

voevoda 7 years, 6 months ago

The state is facing a large deficit. Let's not waste state money tilting at the windmill of federal law or amending our state constitution. The current health insurance law actually benefits the state (or so says state Insurance Commissioner Sandy Praeger, a Republican). The state legislature needs to focus on ways to raise more revenue. How about raising the top tax rate on the top 1%?

jafs 7 years, 6 months ago

Auto insurance regulations are enacted by states, not the federal government.

The question is whether the federal government, under the Commerce clause, has the right to require purchase of health insurance (or payment of a fine) as part of regulating interstate commerce.

Mike Wasikowski 7 years, 6 months ago

"The question is whether the federal government, under the Commerce clause, has the right to require purchase of health insurance (or payment of a fine) as part of regulating interstate commerce."

Not quite. The relevant enumerated power is the Necessary and Proper Clause. Why is that?

One of the most supported changes across all demographic groups in the HCR law is the amendment to the Public Health Service Act that guarantees issue and renewal of health insurance contracts. In other words, you can't be denied insurance because of a pre-existing condition. As far as I know, nobody denies that this is a legitimate use of Congress's power to regulate interstate commerce through the Commerce Clause.

The problem with forcing insurance companies to offer everyone a policy who wants one is adverse selection: healthy people will not purchase insurance knowing that when they get sick, they can still get insurance. That drives the insurance plan into a death spiral. One way to keep the insurance plan's costs from dramatically rising is to grow the risk pool. You do that by increasing the number of healthy people that get insurance. That's what the individual mandate does. It's necessary to avoid a death spiral.

Are there other options to fix the issues from the guaranteed issue and renewal regulation? That's entirely possible. Maybe the subsidies will encourage enough people to sign up to avoid the death spiral (though the legitimacy of the subsidies could be questionable without the mandate). Maybe there's an idea out there somewhere that hasn't been brought to the table yet. But if there aren't other working ideas, it's hard to argue that the individual mandate isn't necessary and proper and, thus, a legitimate exercise of Congress's power through the Necessary and Proper Clause.

just_another_bozo_on_this_bus 7 years, 6 months ago

"Are there other options to fix the issues from the guaranteed issue and renewal regulation?"

One way to do it would be to automatically enroll everyone in an expanded Medicare, and there would be expanded payroll taxes to cover those expenses. If someone wants to opt out, they can buy insurance from a private insurer instead.

But, of course, private insurers exist to make a profit, not to provide health insurance, which would put them at a competitive disadvantage. Which is why they so vehemently oppose a public option.

Paul R Getto 7 years, 6 months ago

Not getting the uninsured 'into the boat' is and will continue to be a problem. I suspect it's illegal or, perhaps, unconstitutional, but getting rules in place that refuse medical treatment, ambulance rides and hospital care to anyone without insurance or a few hundred grand in their pocket should do the trick. This will be an interesting debate. There is no way to prevent rising medical costs; there are, however, strategies to expand the pool and to slow down the rate of increase. We shall see.

voevoda 7 years, 6 months ago

The most cost-effective solution to the health insurance conundrum is a single-payer plan. It cover everyone, regardless of their health status, age, or employment status. For people who currently carry comprehensive health insurance, it would cost less. For people who can't get or can't afford coverage, it would take away their worries. It would get employers out of the health insurance business altogether, saving a lot of bureaucratic costs. It would save the country billions of dollars in the costs of administering health insurance and lower the costs of health care.
What's standing in the way? Rich insurance companies who don't want to lose their profits. Rich people who don't want to share their health care services with the less well-to-do. Ideologues who would rather uphold ideological purity ("free market capitalism") than solve the problems of our country. The far right-wing propaganda machine that whips up hysteria ("death panels" "government-funded abortions") to confuse the electorate and get its candidates into public office.
Think of it this way: the expansion of the health care system provided to Congress, extended to all of us. Or an expansion of the VA system to all of us.

Maddy Griffin 7 years, 6 months ago

Agree! I wish Obama wasn't trying so hard to get along with the other side of the aisle that he ends up caving in on some of his best ideas. I cannot afford health insurance for myself, but my taxes help pay for Congress" health insurance. I want what they have. I really believe there should be "Medicare for all."

Paul R Getto 7 years, 6 months ago

Voevoda: I completely agree, but the administration wimped out on this one, most likely responding to pressure from the R's. As you point out, no one (posters here included) will suggest changes to any system if it looks like it will cost them money. We have always had 'death panels' in the medical/insurance industry. They are called accountants.

Centerville 7 years, 6 months ago

The best way to deal with this is to get the federal pin heads out of the system and allow doctors and hospitals to directly charge, and directly collect from, the patients they serve. Some people would opt to private pay, some would opt to take the chance on having to pay off a big medical debt if they get sick, but most would get HSAs or insurance.

Richard Heckler 7 years, 6 months ago

People in america must realize sooner or later privatization is a magic bullet for increasing the cost of most anything. Why do legislators love to talk about privatization? More than likely these ideas come from their special interest campaign money sources WHO WANT our tax dollars flowing their direction = guaranteed profits. Leave medicare and Social Security alone!

In america trillions of tax dollars are collected annually. So everybody in the USA is paying taxes somehow let's not play pretend.

The answer is we divert the appropriate amount of tax dollars annually to cover the cost of IMPROVED Medicare Insurance for ALL so that clinics and hospitals always get paid. This way new business is created and new jobs will be required to fill the demand.

Reducing the pork barrel military spending by 50% would be more than adequate to cover the cost. Eliminating pork barrel tax dollar subsidies to wealthy USA corporations would be enough to create a reserve fund aka planning ahead. Let them stand on their own.

AND we ignore the misinformation coming from special interest tax dollar junkies aka the Chamber of Commerce and the medical insurance industry neither of which provide medical care.

The U.S. health insurance system is typically characterized as a largely private-sector system, so it may come as a surprise that more than 60% of the $2 trillion annual U.S. health care bill is paid through taxes, according to a 2002 analysis published in Health Affairs by Harvard Medical School associate professors Steffie Woolhandler and David Himmelstein.

5 Social Security Myths from MSNBC

Richard Heckler 7 years, 6 months ago

Let's reduce health care costs by getting rid of the medical insurance industry. Why? Because the medical insurance industry does not provide health care. But they are a whopping expense. And most consumers do not spend what is paid out annually per policy.

Improved Medicare Insurance for All would provide real medical insurance reform!

The United States spends twice as much as other industrialized nations on healthcare – $8160 per capita – yet performs poorly in comparison and leaves over 46 million people without health coverage and millions more inadequately covered.

Expanded and Improved Medicare Insurance for All is one of the solutions.

  • Easy to Implement: Medicare has been in existence since 1966, it provides healthcare to those 65 and older, and satisfaction levels are high. The structure is already in place and can be easily expanded to cover everyone.

  • Simple: One entity – established by the government – would handle billing and payment at a cost significantly lower than private insurance companies. Private insurance companies spend about 31% of every healthcare dollar on administration. Medicare now spends about 3%.

  • Real Choice: An expanded and improved Medicare for All would provide personal choice of doctors and other healthcare providers. While financing would be public, providers would remain private. As with Medicare, you choose your doctor, your hospital, and other healthcare providers.

  • State and Local Tax Relief: Medicare for All would assume the costs of healthcare delivery, thus relieving the states and local governments of the cost of healthcare, including Medicaid, and as a result reduce State and local tax burdens.

  • Expanded coverage: Would cover all medically necessary healthcare services – no more rationing by private insurance companies. There would be no limits on coverage, no co-pays or deductibles, and services would include not only primary and specialized care but also prescription drugs, dental, vision, mental health services, and long-term care.

  • Everyone In, Nobody Out: Everyone would be eligible and covered. No longer would doctors ask what insurance you have before they treat you.

  • No More Overpriced Private Health Insurance: Medicare for All would eliminate the need for private health insurance companies who put profit before healthcare, unfairly limit choice, restrict who gets coverage, and force people into bankruptcy.

  • Lower Costs: Most people will pay significantly less for healthcare. Savings will be achieved in reduced administrative costs and in negotiated prices for prescription drugs.

All the above would significantly reduce the cost of all government and public school districts!

Maddy Griffin 7 years, 6 months ago

Insurance is like gambling. You can pay into it for many years and never get anything back.I've paid the insurance on my car(s) for many years and never had an accident or any reason to collect on it. I've probably paid enough in 37 years to buy a brand new car! I paid into a health insurance through my job or many years but never got any of that back when the job ended either. It's just a crap-shoot.

Flap Doodle 7 years, 6 months ago

A search on "Most people will pay significantly less for healthcare" + merrill found 68 hits. Give it a rest, bub.

Flap Doodle 7 years, 6 months ago

In other health-related news: "US diplomatic cables released by Wikileaks show that the government of Cuba banned Michael Moore's 2007 documentary, Sicko, "because it painted such a 'mythically' favourable picture of Cuba's healthcare system that the authorities feared it could lead to a 'popular backlash', according to US diplomats in Havana." What, those gleaming hospitals aren't available to everyone in Cuba? And you can't believe everything you see in a Michael Moore movie? Say it ain't so!..."

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