Affordable Care Act can’t seem to get traction in Kansas

? “Obamacare was not popular in Kansas,” Lt. Gov. Jeff Colyer told legislators last week in explaining various reasons why Gov. Sam Brownback rejected a $31.5 million federal grant to set up a system required by the Affordable Care Act.

That could be the understatement of the year as far as the Kansas Legislature and Brownback go.

As a U.S. senator, Brownback, a Republican, voted against the ACA that was signed into law by President Barack Obama. As a candidate for governor, Brownback argued for its repeal.

And as governor, he has pushed for a legal challenge of the reform law, signed legislation passed by the Legislature aimed at neutralizing it in Kansas and has now moved administratively against it.

Many Republicans in the Legislature say they hope for the end of the ACA either through a U.S. Supreme Court decision or a GOP victory in the next year’s presidential election.

State Rep. Peggy Mast, R-Emporia, said, “It was a political decision to pass” the law, and she said a political decision may kill it, noting next year’s congressional and presidential elections.

The $31.5 million “early innovator” grant rejected by Brownback was for Kansas to implement a health insurance exchange. Under the ACA, the exchanges are to be used by individuals and small businesses to shop for health insurance. The exchanges are required to be in place by 2014, and the grant would have allowed Kansas to develop the model that could have been used by other states.

Kansas Insurance Commissioner Sandy Praeger said many who oppose the ACA — on both the right and left — hope it will fail and see “anything done to facilitate (the law) could undermine the lawsuits.”

But Praeger, a Republican, and many Democrats say the ACA is the law of the land and planning should be going on now to implement it.

Praeger has refuted the administration’s claims in turning down the grant.

Brownback and Colyer have said there were too many strings attached to the grant. But Praeger said the U.S. Department of Health and Human Services has accommodated states, asking them to come forward with ideas and recommendations.

Colyer also said that the exchange would be determining whether end-of-life treatments were too costly. Praeger said that wasn’t true.

Praeger said regardless of one’s opinion on the ACA, “This is a private-insurance approach to make the private-insurance market work. If the law does go away, we still have a dysfunctional health insurance system that we have to fix.”

While polls indicate the public is divided on the Affordable Care Act, supporters of the law say most people agree with its various components, such as prohibitions on pre-existing condition exclusions for children, extended access to insurance for young adults and prohibitions on lifetime dollar limits in health plans.

Despite Brownback’s rejection of the grant, Praeger continues to do the planning work for the exchange. But when asked if she was trying to do an end-run around the Legislature to install a health insurance exchange, she said, “That would be impossible and I wouldn’t want to do it anyway.”