Martin Hawver
Guest Columnist
Some of us Statehouse old-timers are already double-checking the ink in our pens and putting aside a new notebook for what promises to be the most politically divisive bare-knuckles hearings of the Kansas legislative off-session.
The hearing is about health care, and it’s about that health insurance exchange that is a key to the Affordable Care Act—you know, the one that many call, well, the Affordable Care Act, and that many call “Obamacare.”
It’s one of those issues that has caused bitter disputes in (mostly) the Republican Party that will play out in next summer’s primary elections for legislative seats. Both factions of the Republican Party plus the Democratic Party will be watching the hearing closely.
At the Sept. 19 meeting of the Joint Committee on Health Policy Oversight, Lt. Gov. Jeff Colyer—the Brownback administration’s quarterback on all things health-related—will be explaining why an $85 million program for making sure that nobody’s cheating the Medicaid health-care system for the poor isn’t a prelude to a health insurance exchange.
That exchange is a key because if the Affordable Care Act makes it though dozens of court challenges probably leading to the U.S. Supreme Court (either before or after the 2012 election at which President Barack Obama stands for reelection), we’re going to need a system so that everyone who is by federal law required to buy health insurance under the Affordable Care Act has a place to buy it.
The hearing will inevitably swing to the argument about whether the federal government can force people who can afford it to buy health insurance. That’s the key: The federal government forcing Kansans to spend money on health insurance.
It isn’t just about health care, it’s about who has to pay for it, a political firestorm for conservatives.
The real issue will be the degree of honesty about who pays for health care.
We care for the poor who simply can’t afford insurance because, well, that’s what Americans do. Often the government pays the medical bills for the poor, but you help—and not just through taxes, but by higher insurance premiums if you buy insurance or see your employer deduct a healthy percentage from your paycheck to pay for employer-provided health insurance.
But what about that guy sitting beside you at the doctor’s office who drove a nicer car to the office than you did and who chooses not to buy health insurance—and who might get medical care for free that drives up your health premiums?
But making that guy-with-the-better-car buy health insurance? And, creating an exchange where he can be sent to buy that insurance?
Key at the hearing will be explaining why that new program to make sure nobody’s cheating Medicaid out of free health care doesn’t also identify people who ought to be directed to that exchange, if the courts uphold the mandatory insurance provisions of the Affordable Care Act.
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