Archive for Tuesday, October 4, 2011

Statehouse Live: Without a state health insurance exchange, feds will take over major portions of system, official says

October 4, 2011, 10:05 a.m. Updated October 4, 2011, 3:10 p.m.

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— If Kansas doesn’t put together its own health insurance exchange, the federal government will install one, taking over major portions of the health care system in the state, an official said Tuesday.

“It takes huge control away from states,” said Linda Sheppard, director of the health and accident division of the Kansas Department of Insurance, about a federally implemented exchange.

Gov. Sam Brownback rejected a $31.5 million federal grant to help set up a Kansas-designed health insurance exchange. He said there were too many strings attached to the grant, although he had earlier supported it and some of the contentions by his administration about the exchange have been refuted.

Critics of Brownback have said he rejected the grant to appease those who oppose any movement to prepare for the federal Affordable Care Act.

The health insurance exchanges are a key provision under the federal law and are required to be in place by 2014. The exchanges will provide a one-stop marketplace for hundreds of thousands of Kansans to purchase health insurance. The exchange will also determine eligibility for subsidies to buy coverage.

If a state doesn’t design its own exchange, the federal government will step in and do it, said Sheppard, who recently attended meetings in Washington, D.C., with officials from the U.S. Department of Health and Human Services to discuss what an exchange would be like if the federal government implemented it in Kansas.

On Tuesday, she reported about those discussions to a working group that is handling health insurance reform issues.

Sheppard said she was told a federally implemented exchange would determine eligibility for Medicaid, enrollment of consumers in qualified health plans, and what coverage insurance plans would offer.

“They (the federal government) would be taking over eligibility and enrollment,” Sheppard said. “They would be determining who was eligible and tell states who you need to cover. It would take eligibility control over the states.”

Sheppard added, “We communicated with them we didn’t like that.”

She said that the federal officials said they were open to ideas and recommendations from the states.

“There was some sense they were open to talking to us,” she said.

Several members of the working group said failure by Kansas to establish an exchange could jeopardize potential Medicaid reforms.

Comments

Evan Ridenour 3 years, 6 months ago

No one ever claimed Brownback was rational. He turned down $30+ million dollars claiming accepting money would increase federal regulatory burden on the state when in reality the opposite was true.

It isn't like Brownback shouldn't have known this either because Sandy Praeger, the Kansas Insurance Commissioner... who I might add is a REPUBLICAN... has been arguing this very fact since before the irrational, nay asinine, decision was made.

Welcome to Brownbackistan!

Jan Rolls 3 years, 6 months ago

The sham didn't want federal money now is is accepting federal money to go overseas with farmers from two other states. Sam couldn't find one kansas farmer to go with him. What a nitwit.

newmedia 3 years, 6 months ago

Let's all repeat it together, slowly now - Obamacare.

meggers 3 years, 6 months ago

The law is called the Affordable Care Act, despite what Fox would have you believe.

Crazy_Larry 3 years, 6 months ago

The Patient Protection and Affordable Care Act (PPACA). The PPACA and the Health Care and Education Reconciliation Act of 2010 were products of the 111th United States Congress. http://docs.house.gov/energycommerce/ppacacon.pdf

rtwngr 3 years, 6 months ago

The law is called socialism. MSNBC would have you believe its candy.

voevoda 3 years, 6 months ago

rtwngr, The health care act as it was passed isn't "socialism." It's state capitalism: everybody has to buy health insurance from private vendors. That's the basis of the Supreme Court case: can citizens be required to buy something from a private company? If the system were truly "socialist," with the government providing health insurance out of its general revenues, there wouldn't be any Constitutional issue at all, any more than there is for Federal funding for road construction.

jafs 3 years, 6 months ago

You're right at first.

But, if there were a truly socialized health care system, it would be government delivery of health care, not health insurance.

And, with that or Medicare for all, there might be a valid constitutional issue of whether the government has the right and authority to institute such a system.

Richard Payton 3 years, 6 months ago

What's affordable to the government might not be for you. I've read that 9.5% of your income is considered affordable to the government stated an MSN reporter that writes for the money section. The impression that this 2014 new insurance plan is affordable is a farce. If I have to pay 9.5% of my income for insurance that seems high to me. I would most likely qualify for some relief of some sorts but for the person that doesn't is 9.5% fair?

jafs 3 years, 6 months ago

Well, let's think about it.

If you make $30,000/year, that is $2,500/month gross income. 9.5% of that would be less than $250/month.

Sounds affordable to me, especially if folks who really can't spare it get some help.

In fact, if you could find an insurance policy for that, I'd be very surprised, if it covers much of anything at all.

Richard Payton 3 years, 6 months ago

Are you suggesting the federal government insurance policies will cover more than public policies cover? From looking over the high risk policies the price seems high with few signing up.

jafs 3 years, 6 months ago

High risk policies are always more expensive than normal ones.

And, there aren't any "federal government insurance policies" - all of the policies would be private insurance.

Does $250/month (actually a bit less) sound high with a salary of $30,000/year to you?

I'd bet you can't find a decent insurance policy for $250/month right now.

xclusive85 3 years, 6 months ago

Jafs, are you talking take home pay of 30,000? Or are you talking a salary of 30,000 before taxes? It makes a huge difference. Also, for someone on a $30,000 salary before taxes with say $150/mo in student loans, maybe a $200/mo car payment, $400/mo rent + utilities plus possibly some other bills adding $250/mo to that does seem quite expensive.

jafs 3 years, 6 months ago

I'm not sure how the 9.5% is calculated, so I don't know whether it's on gross or net income.

Also, I don't know where the subsidies end, so somebody at that level might get subsidized.

To me it doesn't sound like a lot, especially if it's a decent policy - we're paying more than that for my policy now, which is a group one through an employer.

jafs 3 years, 6 months ago

I agree, actually, that the mandate is an over-reaching use of the ICC, and not what it was intended for.

We'll see what the SC says.

Jeff Kilgore 3 years, 6 months ago

Your federal government comment is wrongheaded, but then, you rely on foxnews which says it all. The federal government does hundreds of things well. I'll list many: NASA, the CDC, the US Post Office, public education, (and where it's incompetent, unfair advantages give poor students bad schools,) NOAA, and others.

And this black hole of waste shows how little you understand the aspect of scale in math: 31,000,000 is the "black hole" you believe in. 3,000,000,000,000 is our never-ending black hole of expenditures in the Middle East for the past decade which means that those terrorists caused a once rational thinking nation to completely spend itself into insolvency. The black hole I see is 96,7444 times larger than your black hole. Worse yet, we expect our children and grandchildren to pay for it! How's that for patriotism? And you talk of the black hole of waste of not caring for its citizens?

Amazing.

rtwngr 3 years, 6 months ago

The only black hole I see is the one sucking the light out of your argument which is the most convoluted piece of writing I have ever had the displeasure of reading. If you think the government can do anything better than the private sector you are seriously deluded.

Kyle Chandler 3 years, 6 months ago

very fascinating rtwngr, id like to hear more about the 'good' corporations are doing for the economy. Or the 'private sector' as you call it.....c'mon...im waiting...

jafs 3 years, 6 months ago

Then we should immediately privatize the military, no?

That works out so well with those private military contractors like Halliburton, etc. - oh wait.

Crazy_Larry 3 years, 6 months ago

The military! They do spend/waste money well....they're without peer in that category. Wasting money, lives, whatever. The MICC always has been and always will be--apparently. General Smedley Butler tried to warn everyone back in 1935. War is a Racket! http://www.youtube.com/watch?v=EmhZ8pap1hM General Eisenhower warned us again on January 17, 1961: Eisenhower Farewell Address http://www.youtube.com/watch?v=CWiIYW...

10 September 2001: Pentagon Cannot Account For $2.3 Trillion. http://www.youtube.com/watch?v=jjcRyw...

The cake is a lie!

voevoda 3 years, 6 months ago

The VA health care system is so good that many veterans choose to use it even if they could afford to go private. Why not extend it to the rest of the US population? That could be the "public option" that the right-wing propaganda squad scared Congress away from.
Of course, if the public option had been approved, then 1) private insurance premiums wouldn't be going up, because they'd have competition; 2) there would be no basis for the pending Supreme Court case about the Constitutionality of the law, because nobody would be required to buy a private product. Time to revisit the public option!

mloburgio 3 years, 6 months ago

Fourteen Propaganda Techniques Fox "News" Uses to Brainwash Americans It is ironic that in the era of 24-hour cable news networks and "reality" programming, the news-to-fluff ratio and overall veracity of information has declined precipitously. Take the fact Americans now spend on average about 50 hours a week using various forms of media, while at the same time cultural literacy levels hover just above the gutter. Not only does mainstream media now tolerate gross misrepresentations of fact and history by public figures (highlighted most recently by Sarah Palin's ludicrous depiction of Paul Revere's ride), but many media actually legitimize these displays. Pause for a moment and ask yourself what it means that the world's largest, most profitable and most popular news channel passes off as fact every whim, impulse and outrageously incompetent analysis of its so-called reporters. How did we get here? Take the enormous amount of misinformation that is taken for truth by Fox audiences: the belief that Saddam Hussein had weapons of mass destruction (WMD) and that he was in on 9/11, the belief that climate change isn't real and/or man-made, the belief that Barack Obama is Muslim and wasn't born in the United States, the insistence that all Arabs are Muslim and all Muslims are terrorists, the inexplicable perceptions that immigrants are both too lazy to work and are about to steal your job. All of these claims are demonstrably false, yet Fox News viewers will maintain their veracity with incredible zeal. Why? Is it simply that we have lost our respect for knowledge? http://www.truth-out.org/14-propaganda-techniques-fox-news-uses-brainwash-americans/1309612678

sciencegeek 3 years, 6 months ago

Health premiums were raised by insurance companies before they were locked in by the restrictions in the act. Sounds to me more like corporate greed than anything. That's a topic you'll never hear about on fox "news".

Alceste 3 years, 6 months ago

Thank God Brownback was so stupid he sent that money back. The Exchange which will be written by cooler heads in Washington for Kansas will be heads and shoulders above ANYTHING the rubes in Topeka could even make a best case scenerio.

Hooray for Kansas! We'll have something of quality as it relates to health care instead of the Grade D- stuff these Kansas hicks dream up.....

Alceste 3 years, 6 months ago

Let me correct my post, please:

Thank God Brownback was so stupid he sent that money back. The Exchange which will be written by cooler heads in Washington for Kansas will be heads and shoulders above anything the rubes in Topeka could even attempt to make a "best case scenerio" effort, even though their "best case scenerio" would be laughable.

Hooray for Kansas! We'll have something of quality as it relates to health care instead of the Grade D- stuff these Kansas hicks dream up.....

WilburM 3 years, 6 months ago

Insurance Commissioner Sandy Praeger could have put together an excellent, Kansas-oriented exchange. But BB ripped the responsibility and the opportunity right out of her hands, along with the $30 million.

JayhawkFan1985 3 years, 6 months ago

Another step in the radical right's "Great Leap Backward." The 99% of us that own only 60% of the nation's wealth don't deserve fancy things like affordable health care. That should be reserved for the top 1% that own 40% of the nation's wealth. The Kansas Policy Institute will tell you that we just can't afford things like the Affordable Care Act. I believe we can't afford to NOT have the Affordable Care Act. Don't be a mindless stooge of the Koch Brothers as the KPI is. THINK for yourselves.

I believe the time has come for FDR's Economic Bill of Rights which includes health care and education as fundemental rights. These are things KPI is actively trying to undermine with the help of Governor Brownback and our current Legislature. Fortunately, Commissioner Praeger is an "Old School Kansas Republican" cut from the same cloth as President Eisenhower and Bob Dole. The Tea Pary and its ilk are more like the Taliban and the Nazis.

Bob Burton 3 years, 6 months ago

You Burkeley East guys should not get your shorts in a twist just yet as they do not have to have a plan until 2014.. I would think that 2 years should be plenty of time to get one in place..

Have a great day and enjoy the cool weather..

jafs 3 years, 6 months ago

"Berkeley"

We'll see what kind of plan can be implemented, given vigorous Republican opposition.

KCKKid 3 years, 6 months ago

"...get your shorts in a twist just yet as they do not have to have a plan until 2014."

Have a plan, and IMPLEMENT a plan. How long do you think it takes to implement something this big? It's taking the federal government four years with unlimited money.

The federal government won't wait until 2014 to put their plan in Kansas.

If the law doesn't get overturned, Kansas will have a federal exchange.

Alceste 3 years, 6 months ago

KCKKid notes:

"If the law doesn't get overturned, Kansas will have a federal exchange."

Comment: That'll be a GOOD THING. Kansas is not capable of creating an equitable, feasable, or practical plan as it is presently controlled. Kansas would have a difficult task even IF Brownback wasn't in office. Face it: Kansas is a backwater, hillbilly laden state.....

KS 3 years, 6 months ago

The same folks that can't run the post office or protect your social security will run your Obamacare? I can't wait. BTW, when a baby is born, will that child be expected to write a check within 30 days for the first premium? What happens when they don't? It will be the law you know. Don't say it will be the parents' responsibility. Some of those folks won't pay for their auto insurance or taxes! Bet they will pay for cable tv and the internet, along with that cell phone though. What shall we do? Just what shall we do? Oh, silly me, just let everyone else pay for it. Healthcare is supposed to be free, right?

George_Braziller 3 years, 6 months ago

The postal service isn't really a governmental entity. It hasn't been since the Nixon administration.

KS 3 years, 6 months ago

If the Post Office is not a government entity, why do they have to ask Congress for permission to stop Saturday delivery? Who paid for the post office locations? The taxpayer over the years, that's who!. Why do they put up "property of the US Government" signs around a post office?. Steal some mail and see who shows up at your front door to arrest you! Don't know what you mean by "isn't really". It either is or it isn't. Like being half pregnant. No such thing.

Kyle Chandler 3 years, 6 months ago

Oh you are so right, i think we should just bail out some more corporations instead of implementing a bill that funds health care and education. i think we should call it 'CORPORACARE'

George_Braziller 3 years, 6 months ago

It's considered an independent entity. Congress approves policy for its operation but doesn't provide any funding.

voevoda 3 years, 6 months ago

These are the same folks that have created and maintained the best military in the world. Some things the government does are done very well indeed!

Crazy_Larry 3 years, 6 months ago

The post office has done fairly well throughout history. The financial problems of today are relatively new. The USPS' economic crisis is the result of a provision of the Postal Accountability and Enhancement Act of 2006, which requires the Postal Service to pre-fund the healthcare benefits of future retirees -- a burden no other government agency or private company bears. The mandate requires the USPS to fund a 75-year liability over a 10-year period and costs the USPS more than $5.5 billion per year. The post office was basically forced into bankruptcy by BushCo. with the passage of the PAEA of 2006.

APWU President Cliff Guffey on FOX TV 5, Aug. 12, 2011. http://www.youtube.com/watch?v=rF7PgP...

Flap Doodle 3 years, 6 months ago

"Let 'em go" Holder will be needing a new gig soon (unless he's in prison). Sounds just right for a forgetful individual like him.

KS 3 years, 6 months ago

Holder will lie himself out of this one!

KuGal12426 3 years, 6 months ago

LOVE all the comments on this being unconstitutional...

We opted for a strong central government a LONG time ago and that was because each state having too many rights creates complete chaos... The federal government is within its constitutional rights (the constitution was intentionally written to be open to various interpretations)

I think Brownback is egotistical and puts political bs before the well-being of Kansans.

Personally, I think the post office is a necessary national institution that needs to stay--heaven forbid we outsource the postal service and I have to pay 10x the annual fee for my P.O. Box that I'm paying now...

As for everyone else paying for poor, lazy people's healthcare...we've had social welfare programs for quite some time now...they are there for a reason and the minute you or your loved ones NEED them, you'll get it PERSONALLY I get much MORE angry about the people who are obscenely wealthy and don't properly contribute (through taxes) to the country that enabled their success than I do about lazy people living off of social welfare programs that barely keep them in their slummy apartments and sodium-rich instant meals.

[Not to mention I've been hearing a recent trend that entitled OP kids are pulling out food stamps while living off of their parents? Anyone know if there is truth to this, or is it just a disgusting rumor?]

Rockchalk--I'm aware that the ljworld isn't exactly and unbiased middle-of-the-road news source...but do you think you are going to sway anyone on here by citing Fox News and a GOP website? and then stating that the military is the only thing run properly...I mean come on...Republican rhetoric 101!

Why do I let these articles and everyone's comments get me so worked up...?

jafs 3 years, 6 months ago

The question is whether the ICC (Interstate Commerce Clause) allows the federal government to mandate individual purchases of health insurance or not.

If it does, then that seems to open the door to the federal government mandating individual purchases of just about anything, which doesn't seem right to me.

The original idea of the ICC wasn't to do that - it was to allow the federal government to regulate interstate commerce, making rules, etc. when states trade with each other, which is a very different thing from the insurance mandate.

KuGal12426 3 years, 6 months ago

I may be confused...and I understand what you are explaining is certainly far from ideal...But isn't this just a response to Brownback's "eff you" to the federal grant? That's what I understood it to be, but I could be confused (these things can be super confusing and I genuinely strive to try and understand, not just repeat what I hear). And if this is indeed a response to Brownback's "eff you," then how is the federal government expected to respond? To me it seems like Brownback asked for this and enjoys every moment of it...

jafs 3 years, 6 months ago

I was just responding to your comment that the federal government is within it's rights.

There's certainly a question there on this one, to my mind.

And no, I think the federal government is implementing these exchanges when states don't simply in order to implement the policy.

pinecreek 3 years, 6 months ago

It is simply amazing at the vitriol that has been put into place for the attempts to correct some of the imbalances in health care delivery in this country. The unfortune outcome is that Obama's plan has come nowhere close to fixing the economic train wreck that will be the US 20 years from now due to health care costs. The other unfortunate outcome is that all of the so-called 'economic conservatives' have presented no viable counter proposals to make healthcare affordable in this country now and in the future nor have they even proposed how to manage--not destroy--Medicare (alone) in a way that doesn't bankrupt America.

At 17% of GDP and climbing each year, it's ironic that healthcare delivery in this country has become an economic cancer that no one will talk about or diagnose in a rational way, let alone attempt a true cure. With this level of polarization and contempt from all sides for all sides, we will get exactly what we deserve.

Getaroom 3 years, 6 months ago

It is greed and war that has bankrupt this country, not Medicare and Social Security. Without a form of healthcare that includes all of our citizens, in a relatively short span of time there will be no one left to do the labor and keep infrastructure operating. Like it or not, we are all in this together. If you keep believing in the lie that the super wealthy are the ones providing the jobs and only they can save us, well, keep on believing it and see where you end up.

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