It’s been hard to keep up with the many recent changes in the American health care system, but Kansans now have to consider a new wrinkle that state officials have thrown into the mix.

Last week, Kansas Gov. Sam Brownback signed legislation that makes Kansas part of an interstate compact with eight other states that want to regulate their own health insurance systems. If the compact is approved by the U.S. Congress, the states would be allowed to break away from the Affordable Care Act and the federal Medicare system and replace them with state-administered programs.

Supporters of the bill acknowledge that a key goal of the measure is to send a message to the Obama administration about their displeasure with ACA, but the impact of the bill could be profound for Kansans.

The compact legislation will have no practical effect unless the multi-state compact Kansas will join is approved by Congress. Many Kansans would consider that a long shot, but they probably thought the same thing about a number of measures that have found their way into the state’s law books this year. If midterm elections should produce Republican majorities in both the U.S. House and Senate, the possibility of the compact being approved are greatly enhanced.

If that happens, what’s next for Kansas? That’s what concerns Kansas Insurance Commissioner Sandy Praeger, who joined with the Kansas AARP and other state groups to oppose the bill. “When we have a state that is willing to turn their back on the Medicaid expansion, I have to question going forward what could happen potentially to the Medicare program if it is being run on the state level.”

On the other side of the issue were groups like Americans for Limited Government, who called Praeger to task in a news release for her “erroneous statement that the bill offers no clear plan for how the compact might be administered.” The news release explained that the compact “will empower Kansas to administer federal funds for health programs. It’s really as simple as that. It would be up to the state legislature to work out the details.” Rather than proving Praeger’s error, the ALG statement actually raises the question of whether state legislators would be able to develop a plan that’s better than the highly debated Obamacare.

Kansans, especially those who depend on Medicare, find themselves in a no-man’s land, not knowing who to believe in the national health care debate.

State lawmakers wanted to send a message to Washington about the ACA. Maybe state residents now should send a message of their own to state lawmakers who want to dump the federal health insurance and Medicare programs without having a specific plan for how to replace it.