Kansas is primed to get the worst possible outcome of a federally run health insurance exchange, thanks to Gov. Sam Brownback’s decision not to support an application for a state-federal partnership.

Brownback previously rejected $31.5 million in federal funds that were allocated to enable the state to create the computer infrastructure for its own exchange. He said he expected the U.S. Supreme Court to overturn the federal law mandating creation of the exchanges. When that didn’t happen, he said he would await the outcome of the presidential election, assuming that Republican Mitt Romney would be elected and quickly have the law erased from the books. So much for that.

All along, the Kansas Insurance Department, guided by Lawrence’s Sandy Praeger, insurance commissioner, has been laying the groundwork for an exchange that could be operated by Kansans, for Kansans. Her staff had prepared an application that would have enabled Kansas to fill the roles of plan management and consumer assistance. Kansas would have received federal funds to spend on creating the partnership exchange, but only if Brownback supported the application for the funds and the 2013 Legislature authorized their expenditure.

Bye-bye. Kansas will have to live with the federal exchange. Apparently the governor is sticking us with the least palatable alternative, probably deliberately. His explanation rings hollow.

“My administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it, and implementing it could cost Kansas taxpayers millions of dollars,” he said.

So Kansas will get the federal exchange. The expectation is that the default benchmark plan for Kansas now will be the largest health plan by enrollment in the state’s small group market. This is the Blue Cross Blue Shield of Kansas Comprehensive Major Medical – Blue Choice PPO product, amended to meet all the “essential health benefits” mandated by the federal plan. For plan years 2016 and beyond, the U.S. Department of Health and Human Services will revisit the “essential health benefits” benchmark approach to ensure that the EHB continues to reflect appropriate medical practices and insurance market protocol.

As William Allen White, the Emporia editor wrote in 1896 in his famous screed, “What’s the Matter with Kansas?”: “Go east and you hear them laugh at Kansas; go west and they sneer at her; go south and they cuss her; go north and they have forgotten her. Go into any crowd of intelligent people gathered anywhere on the globe, and you will find the Kansas man on the defensive. The newspaper columns and magazines once devoted to praise of her, to boastful facts and startling figures concerning her resources, are now filled with cartoons, jibes and Pefferian speeches. Kansas just naturally isn’t in it. She has traded places with Arkansas and Timbuctoo.”

If he came back today, White might conclude that little has changed.