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Fact checking: Milton Wolf on health benefit mandates
Two years before entering the U.S. Senate race in Kansas, Dr. Milton Wolf of Johnson County penned a 38-page e-Book published through Amazon in which, among other things, he criticizes former Kansas Insurance Commissioner Kathleen Sebelius.
The book, "First Do No Harm: The President's Cousin Explains Why His Hippocratic Oath Requires Him to Oppose ObamaCare," is part of a series from Broadside Books called "Voices of the Tea Party." In it, Wolf writes:
In my state of Kansas, for example, under our former insurance commissioner (and current Health and Human Services secretary) Kathleen Sebelius, the increased mandates she employed chased nearly a dozen insurance companies out of the state, diminished competition, and left forty thousand Kansans without health insurance.
• Insurance mandates: First, it's important to note that the Kansas insurance commissioner does not have the power to impose new benefit mandates unilaterally. All of the mandated benefits, including those dating back to the 1970s, as well as those enacted since Sebelius left office, were enacted by the Kansas Legislature. Sebelius, however, did lobby in favor of many new mandates while she served as commissioner.
Several paragraphs earlier in his book, Wolf writes dismissively of benefit mandates, saying: "State insurance commissioners, greased by the lobbying machine and eager to promise all sorts of new goodies to voters, mandated that insurance companies wishing to operate in their state provide whatever service they arbitrarily demanded — podiatry, chiropractic, in vitro fertilization, midwifery, acupuncture, radiology, whatever — whether the patients want it or not."
However, very few of those services are actually mandated in Kansas.
The Kansas Insurance Department website provides a comprehensive list of the benefit mandates that apply in Kansas, some of which date back to the 1970s.
Those that began when Sebelius was commissioner (1993-2003) include: mental health prescription drugs (2001); diabetes supplies and equipment (1998); prostate cancer screening (1998); dental anesthesia for children and disabled individuals (1999); breast reconstruction for mastectomy patients (1999); osteoporosis treatment (2001); off-label cancer medications (1999); and well-woman exams (2001).
• Companies leaving Kansas: Wolf argues that those mandates caused insurance companies to leave Kansas, resulting in less competition in the marketplace. It's an argument he has repeated many times, including a 2012 op-ed piece he wrote for the Washington Times, without ever citing a source to substantiate the claim. His campaign did not respond to an email request Tuesday asking for a source.
The issue also came up when Sebelius campaigned for governor in 2002, and the response at that time was that it was the result of mergers and acquisitions within the insurance industry, not the result of coverage mandates.
A spokeswoman for the Kansas Insurance Department said the agency does not track the number of insurance carriers on a year-to-year basis, so they were unable to confirm or deny Wolf's claim. Insurance industry officials, however, say the trend has continued over the last five to seven years, again due largely to mergers and acquisitions, but there have been no new entrants into the Kansas health insurance market.
• Rise in the uninsured: Wolf's claim that 40,000 Kansans lost their health coverage as a result of the mandates comes from a 1988 study by the National Center for Policy Analysis, a free-market think tank, which asserted generally that "as many as one of every four uninsured people lack health insurance because state regulations have increased the price of insurance."
That study has been criticized as flawed for several reasons. For one, it ignored the possibility that high costs in some states were what spurred the new regulations and mandates, not the other way around.
The claim is also contradicted by data from the U.S. Census Bureau that shows the number of Kansans without health insurance actually fell during the time Sebelius was insurance commissioner.
In 1994, the year Sebelius was first elected to that office, the Census Bureau estimated 12.9 percent of Kansans had no health coverage. Based on the state's population at that time of 2,554,047, that translates to roughly 329,472 Kansans uninsured.