By ELISE REUTER
KU Statehouse Wire Service

TOPEKA — Nearly a month after Gov. Sam Brownback signed the Health Care Compact, its implications for Kansas and other states are still unclear.

No matter what policy changes legislators make, according to the Kansas Insurance Commissioner’s office, the state would still be accountable to the federal government on health care issues.

“This law doesn’t really take the Affordable Care Act out of the mix,” said Linda Sheppard, Director of Health Care Policy and Analysis for the Kansas Insurance Department. “Insurance companies in Kansas still have to abide by those laws and regulations in place. This compact really does not address the issue of private health insurance and if any of that has changed.”

Kansas joined eight other states in the Health Care Compact, a piece of legislation currently under discussion in the U.S. House Judiciary Committee. The bill would separate Kansas from federal health care law, allowing legislators full jurisdiction over policy on the state level.

“The topic of health care is too large and too complex for a cookie-cutter approach to be applied broadly across the nation,” Rep. Brett Hildabrand, R-Shawnee, said when he first introduced the bill.

Although Kansas, Oklahoma, Missouri and several other states have passed the compact, it will not go into effect unless it is approved by Congress. To pass, the bill must be adopted in the House and Senate through a majority vote, but does not require the president’s signature.

According to Rep. James Lankford, a Republican from Oklahoma who introduced the Health Care Compact in the U.S. House of Representatives in February, the bill currently has 14 co-sponsors. Advocates estimate that the bill might pass if Republicans are able to gain control of both houses following the November election.

“Washington D.C. does not like letting go of power,” Lankford said. “When you control someone’s health care, you have power over them and their state.”

Advocates of the compact argue that it would give citizens more of a chance to influence health care policy. Lankford argued that it would also reduce fraud, and cultivate policy between states.

“Rather than a one-size-fits-all mediocre solution, we would be able to meet with other states and glean the best ideas,” said Rep. Eric Burlison, R-Springfield, the Missouri representative who was the first state legislator to support the Health Care Compact.

While he has not formally considered any policy changes, Burlison mentioned he had discussed reforming Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals to provide emergency treatment to all patients regardless of citizenship or ability to pay. He added that lawmakers might also want to give some aspects of Medicaid a second look.

Before it was introduced at the federal level, the Texas-based Competitive Governance Action originally drafted the Health Care Compact in 2011. Curtis Ellis, a spokesman for the group, said the compact was designed to “replace Obamacare with something far more flexible, and give power back to the state.”
“Not even in an ideal world, but in the real world, this stands a good chance in Congress,” Ellis added.

While the main impetus for the compact was exemption from the Affordable Care Act, many states have also discussed reforms to Medicare and Medicaid. This has naturally caused some uncertainty among seniors, who might not welcome further changes to their plans. The change in the legislation itself stems from the fact that funding for these programs would no longer be contingent on states adopting federal policies and regulations.

Oklahoma Insurance Department spokeswoman Calley Herth said that both Medicare and Medicaid patients would benefit, while ACA enrollees would be able to keep their plans.

“It’s our belief that they would be eligible to keep the ACA plan if they so choose, but there will be more options and more cost-effective options with similar benefits,” Herth said.

However, not all citizens would reap the benefits. Praeger and the AARP clearly voiced their concerns following the bill’s passage in Kansas, specifically addressing the state’s refusal to expand Medicaid at the cost of senior citizens. Regardless of some opposition, Lankford said some insurance companies support the compact.

“It’s easier to deal with issues at the state level,” Lankford said. “Especially when you’re a smaller hospital or company who might have no voice in Washington D.C., but have a relationship with legislators in state.”

Even with the advantages, the bill’s nebulous language means it’s still difficult to say what specific policies Kansas—and other states—will pursue.

Elise Reuter is a University of Kansas senior from Colorado Springs, Colo., majoring in journalism.