by Andy Marso, KHI News Service
The temporary budget that legislators passed this week includes a provision intended to assure the public that they won’t privatize Medicare under an interstate health care compact.
The compact is an agreement among states to petition Congress for the option to receive federal money for health care programs as block grants free from federal regulations. Kansas is one of nine states that had joined it as of December.
Republicans who control the Kansas Legislature voted to join the compact in 2014 to protest regulations in the Affordable Care Act, commonly called Obamacare.
The compact vote became a surprise issue in the 2014 elections after groups that represent elderly Kansans raised concerns about what it could mean for Medicare.
The groups feared that under the compact the Legislature could take money for Medicare — the federal health care program for seniors — and use it to contract with private insurance companies to administer managed care as the state has done with Kansas Medicaid, which is now called KanCare.
Compact supporters have said that is not their intent. The proviso added to the budget this week specifies that the state could not spend any money to take over Medicare under the compact unless the Legislature votes to do so.
Democrats who opposed the compact from the beginning say that’s not enough assurance.
“It was, I think, a false promise,” said Rep. Jim Ward, a Democrat from Wichita. “Medicare is still in danger.”
Ward introduced an amendment this week to strip Medicare from the Kansas version of the compact agreement, but it failed 33-86.
Some of those who voted against it said they didn’t want to muddy the underlying bill, which dealt with interstate physician licensure and ultimately passed easily.
Compact supporters also warned that any changes like the one Ward proposed would make the compact moot because each state has to pass it with the same language.
Rep. Brett Hildabrand, a Republican from Shawnee who carried the compact bill through the House in 2014, urged his colleagues to continue their support.
“It does not do anything to attack Medicare,” Hildabrand said. “Obamacare is the threat to Medicare, not the health care compact.”
The Affordable Care Act made cuts to privatized Medicare Advantage plans — which have proven more expensive than traditional Medicare plans — to pay for other parts of the health law. But enrollment in the plans continues to rise.
The health care compact needs congressional approval to become law. It is unlikely to pass before the next election and could face a court challenge if it does.
The compact was conceived in 2011 by a nonprofit think tank called the Health Care Compact Alliance, which has since been absorbed by another think tank called Competitive Governance Action. The American Legislative Exchange Council adopted the compact as model legislation.
Bills proposing that Kansas join the compact were first introduced in 2012.
Rep. Sydney Carlin, a Democrat from Manhattan who supported Ward’s amendment, said this week that the compact has “really stirred up the senior citizen community.”
“They’re very concerned about the possibility of the money all coming to Kansas as a block grant,” Carlin said. “They don’t like that.”
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