Kansas Attorney General Derek Schmidt on Thursday joined in another multi-state lawsuit challenging a portion of the Affordable Care Act, this time disputing fees the states claim are an unconstitutional tax on states.
Schmidt, a Republican, joined Louisiana and Texas in challenging fees that are assessed against insurance companies hired to manage state Medicaid or Children's Health Insurance Programs.
The states argue the fees are required to be passed on to the states, making them a "de facto tax" on state treasuries, which they say is unconstitutional.
“If the federal government wants to tax and spend, it may do so within the confines of the law,” Schmidt said in a statement released Thursday afternoon. “But it may not, we think, employ accounting tricks that force the states to do the taxing while the federal government does the spending."
Kansas currently contracts with three private insurance companies to manage its Medicaid program, known as KanCare. Schmidt said in the first year of the tax, the insurance provider fee cost Kansas $32.8 million. The lawsuit seeks a refund of that amount and an order prohibiting future collections of the fee.
The lawsuit, filed in federal district court in Wichita Falls, Texas, is just the latest in a series of legal challenges Schmidt leveled against the Affordable Care Act, also known as Obamacare.
Last year, Schmidt joined with 19 other states in another Texas-led challenge, arguing that since a provision of the law known as the "individual mandate" has been interpreted as a tax, then the law is unconstitutional on procedural grounds because tax bills must originate in the U.S. House, and the Affordable Care Act was a Senate bill.
He has also joined in challenges of the law's mandate that employers over a certain size must provide health coverage to their workers. In that challenge, he argues that the employer mandate should not apply in states like Kansas that chose not to set up their own state-based health insurance exchange markets.
Schmidt also joined in a lawsuit filed by Hobby Lobby that challenged a requirement that employer-based health policies cover contraception.
Republican Gov. Sam Brownback issued a statement supporting Schmidt's lawsuit, calling the provider fee "just one more instance of an overreaching federal regulation designed to coerce states into funding or participating in Obamacare."
People in Kansas and other states that do not operate their own health insurance market exchanges can continue to receive federal subsidies to buy policies on the federal exchange, the U.S. Supreme Court ruled Thursday.
In a 6-3 decision, the court rejected a challenge by plaintiffs who argued that, as written, the Patient Protection and Affordable Care Act, also known as "Obamacare," only allows subsidies to be paid for people who buy policies on state-based exchanges.
The ruling was good news for the nearly 70,000 Kansans, including nearly 5,000 in Douglas County, who have received federal subsidies to buy health insurance in the two years since the law took effect.
But it was a setback to critics of the health care law who hoped that a decision striking down the subsidies would be a death blow to the program that they have characterized as a federal "takeover" of the nation's health care system.
House Speaker Ray Merrick reversed course Thursday and finally agreed to allow committee hearings on the subject of expanding Medicaid under the Affordable Care Act.
Only days earlier, Merrick reportedly had told Reps. Tom Sloan of Lawrence and Barbara Bollier of Mission Hills, both moderate Republicans, that he would not allow such hearings. Sloan chairs the Vision 2020 committee that advanced a Medicaid expansion bill earlier in the session. Bollier, a retired physician, also serves on that committee.
But Merrick was forced to change his mind Thursday when Rep. Jim Ward, D-Wichita, offered an expansion proposal as an amendment onto a minor bill that would authorize the Kansas Medicaid program to pay reimbursements for donated breast milk as a medical treatment for infants.
Because Ward's amendment also dealt with Medicaid, it was considered relevant to the underlying bill, and that could have forced a vote on an issue that GOP leaders weren't fully prepared for. But Ward agreed to withdraw his amendment in exchange for a personal assurance by the speaker that Medicaid expansion would get a hearing.
One of the factors that helped swing the decision, according to Sloan and Bollier, was fresh memory of the previous day's vote on a bill dealing with teacher contract negotiations. Conservatives had brought up a bill that would have taken away the exclusive bargaining rights of teachers unions and given every teacher authority to negotiate contracts individually.
But moderates offered up a substitute bill reflecting a negotiated compromise between the state's largest teachers union and associations representing school boards, superintendents and administrators. The amendment passed on Wednesday, 67-52, and the final bill was approved and sent to the Senate Thursday with 109 yes votes.
"It's the first vote where you could ascertain the ideological bent of the body," Sloan said, referring to the teacher negotiations bill. "That doesn't mean that there are 67 firm votes on everything, but it was a wake-up call."
Bollier said the impact of that vote may extend even further.
"To me it was a definite sign that constitutional changes are going to be incredibly difficult, if at all possible," she said.
Bollier was referring to proposed constitutional amendments that did not reach the floor of the House this week that would change the way Kansas Supreme Court justices are selected.
Constitutional amendments require a two-thirds majority vote in both chambers, followed by a simple majority of voters in a public election.
Another indicator that Medicaid expansion may still have hope in the House came when Rep. Scott Schwab, a conservative Republican from Olathe, stood up to speak on Ward's Medicaid amendment. Schwab said he opposed the amendment, not because he opposed expanding Medicaid, but because he didn't like the method that Ward was calling for.
"I'm not one of the people who are absolutely opposed to expanding Medicaid," Schwab said. "As a matter of fact, I would have rather expanded Medicaid as opposed to doing the ACA altogether. ... If we just said, 'How many people would like to expand Medicaid and help those who need increased access to care but are lacking the resources to get typical day-to-day insurance,' a lot of us would say yes, we want those folks to get access to care. But it's hard to get 63 people (the minimum majority vote in the House) to agree on how to do that."
Ward's amendment would have repealed a law passed last year that requires legislative approval to expand Medicaid under the Affordable Care Act and prohibits the governor from acting on his own. The amendment would have authorized Gov. Sam Brownback to enter negotiations with the U.S. Department of Health and Human Services on a plan for how to implement Medicaid expansion in Kansas.
Sloan pointed out, though, that Ward's proposal did not provide any funding for an expansion. Under federal law, the state would eventually be required to pay 10 percent of the cost of covering those who would become eligible under the expansion.
The bill that the Vision 2020 committee endorsed would levy a fee on health care providers that receive Medicaid reimbursements to cover the state's 10 percent share. In exchange, those providers would receive the remaining 90 percent of funding that would come from the federal government.
In his criticism of U.S. Sen. Pat Roberts, R-Kan., on Monday, Dr. Milton Wolf indicated Republicans shouldn't make friends with Democrats and that New Jersey Gov. Chris Christie's recent controversies have been caused by the media.
Wolf, a tea party-backed challenger to Roberts in the GOP primary, was interrupted several times by applause during his 24-minute talk to about 50 people who attended an event put on by the Douglas County Republican Party at Famous Dave's restaurant.
One of Wolf's major criticisms of Roberts is that Roberts voted in the Senate to confirm President Barack Obama's selection of Kathleen Sebelius in 2009 as secretary of Health and Human Services. Sebelius has been at the forefront of implementing the Affordable Care Act, commonly called Obamacare, which is opposed by all Republicans in Congress.
"One of the problems with our party is too often we're the go-along to get-along party," said Wolf. "We try to get people in the media to like us, we try to get the Democrats to like us. It never works. Ask Chris Christie about that. He can walk on the beach every day of the week with Barack Obama, but as soon as he starts looking like a candidate for the presidency, the media is going to stab him in the back," Wolf said.
In 2012, Christie, a Republican, praised the response of President Obama and the federal government to Hurricane Sandy, which battered the Northeast. Christie's appearances with Obama just days before the presidential election was criticized by some Republicans as helping Obama.
Recently, Christie has been embroiled in controversy over an allegation that his aides closed lanes to the George Washington Bridge in political retribution against a New Jersey mayor.
Wolf added, "You cannot make friends with our adversaries, and yet what we have — and this should trouble us all to know — is we have Sen. Roberts who voted to put Kathleen Sebelius in charge of Obamacare," he said.
Sebelius was confirmed as secretary on a 65-31 vote. Nine Republicans voted for her, including Roberts and then-U.S. Sen. Sam Brownback, a Republican who is now governor of Kansas. In recent months, Roberts has called for Sebelius to resign after the troubled roll-out of the ACA's enrollment website.
The campaign of Dr. Milton Wolf, the Tea Party activist challenging U.S. Sen. Pat Roberts, R-Kan., says Roberts' call for the resignation of U.S. Health and Human Services Secretary Kathleen Sebelius was "too little, too late."
Wolf's campaign said Roberts should apologize for voting to confirm Sebelius as President Barack Obama's secretary of Health and Human Services. Sebelius, a former Kansas governor, is implementing the Affordable Care Act.
"With her help, President Obama and the democrats rammed through the most disastrous legislation in recent history. Senator Roberts owes every American an apology," Wolf's campaign said.
Wolf, a radiologist from Leawood, announced his candidacy in the 2014 Republican Party primary last week. Just days later, Roberts issued a news release, saying that Sebelius, a former Kansas governor, should resign for "gross incompetence" because of glitches in the rollout of the federal online health insurance marketplace under the ACA.
The HealthCare.gov federal website for the health insurance marketplaces has been plagued with technical problems that have prevented many from enrolling.
Sebelius has acknowledged problems and said technicians were trying to expand the site's capacity. The website became operational Oct. 1.
Meanwhile, the Roberts campaign issued a statement saying that it ended the quarter Sept. 30 with $1.8 million cash on hand for the campaign, and touted Roberts' ranking as the fifth most conservative senator, according to Heritage Action.
"Kansans know that Pat is the tough, tested and trusted conservative in this race," said Dave Murfin, of Wichita, and Statewide Co-chair of Roberts for Senate.
Topeka — While politicians fume over the pros and cons of the Affordable Care Act, Kansas Insurance Commissioner Sandy Praeger is providing detailed information about the health law through a website, videos and public meetings across the state.
"We urge you to get the facts for yourself," Praeger said.
The website is insureKS.org, and questions can also be phoned in at 1-800-432-2482. Here is a link to an introductory video on the website.
Information meetings are scheduled next week in Topeka, Independence and Emporia. Posted below are the times and dates.
The ACA requires nearly every adult to purchase a minimum amount of health insurance coverage starting next year or pay a penalty.
Enrollment starts in the new health insurance marketplace on Tuesday. Individuals and small employers can compare private health insurance plans and purchase coverage. The marketplaces also provide tax credits to help lower- and middle-income individuals pay for their policies.
Here is a link to a federal website providing information on the marketplaces.
Brownback remains undecided on Medicaid expansion; supports adult stem cell center; declines to state position on drug testing welfare recipients and relaxing renewable energy standards
Topeka — Gov. Sam Brownback on Wednesday said he hasn't made up his mind on whether Kansas should opt in to a federally funded expansion of Medicaid, but he expressed concerns about the future flow of dollars to the state from Washington, D.C.
In a brief question and answer period with reporters as the 2013 legislative session neared the midway point, Brownback said he was still analyzing data on Medicaid expansion but added that he is worried about future costs.
"We have a lot of pressures on the state budget that are significant," he said. He mentioned a court order to increase school funding, an at-capacity prison system and what he described as high demand for spending on public universities.
In addition, Brownback predicted that federal funding to the state in general would decrease over the next decade because of federal budget difficulties.
Under the Affordable Care Act, the feds would pay 100 percent of the Medicaid expansion costs for three years and then ratchet that down to 90 percent over the next several years.
On other issues, Brownback declined to state his position on bills that would relax renewable energy standards and require drug testing of some welfare beneficiaries.
"We'll see what gets to me," he said of a measure approved by a House committee to rollback the requirements for renewable energy.
On a bill approved by a Senate committee that would require drug tests for recipients of certain benefits, Brownback said, "Let's see what the Legislature puts forward on something like that."
Asked to comment on a Senate committee rejection of his reading initiative, he said he understood it was an emotional subject and that the discussion will continue. The Senate Education Committee defeated Brownback's proposal that would have required schools to hold back students in the third grade if they scored in the bottom performance level on the state's reading test.
On another issue, Brownback expressed support for establishing an adult stem cell center at Kansas University Medical Center.
"Having an adult stem cell center is not only highly plausible, it's being done and used in many places around the world," he said. "If Kansas could take a leadership position in that, it could be a highly useful thing for people to get treatments. There are number of different maladies now being treated by noncontroversial stem cell treatments," he said.
He added, "Let's see what develops in the process and in the bill." The bill would prohibit the center from using embryonic stem cells or cells taken from aborted fetal tissue.
Obamacare health insurance exchanges have been approved in four GOP-led states.
In Kansas, Gov. Sam Brownback rejected partnering with the federal government to set up the web-based insurance marketplaces, saying the Affordable Care Act was an overreach by the federal government.
But in Idaho, a spokesman for Republican Gov. C.L. "Butch" Otter said, "We're on track for Idaho having a say over how this process works, instead of having the federal government dictate all of it."
Here is a link to the story. http://bit.ly/YZsuXr
Group says a number of Kansas Republicans support legislation authorizing the arrest of federal officials who implement Obamacare
Twenty Republicans who are either already serving in the Kansas Legislature, or will be sworn into office in January, say they would support legislation to "nullify" the Affordable Care Act and authorize state and local law enforcement to arrest federal officials attempting to implement it, according to a survey compiled by a group called Campaign for Liberty.
The question from Campaign for Liberty, which was founded by U.S. Rep. Ron Paul, R-Texas, was "Will you support legislation to nullify ObamaCare and authorize state and local law enforcement to arrest federal officials attempting to implement the unconstitutional health care scheme known as ObamaCare?"
I started calling some of those who answered `Yes' to that question, and the first one I reached was state Rep. Jim Howell, R-Derby.
Howell said he is an ardent opponent of the federal Affordable Care Act and would do everything legislatively possible to prevent its implementation but he said he disagreed with the part of the question that dealt with authorizing state and local law enforcement to arrest federal officials to implement the law.
"That is not worded well," Howell said. He said during the course of the campaign, he did not remember responding to that particular survey.
State Rep.-elect Allan Rothlisberg, R-Junction City, also said he was vehemently opposed to the ACA, but the part of the question dealing with arresting federal officials was not something he would support. "Not arrest them but we are just not going to assist them," he said.