By Gene Meyer
Kansas Reporter
TOPEKA — Ticking clocks may be thwarting Kansas’ attempts to avoid new federal health-care regulations that many in the state say they don’t want.
State executives this week briefed legislators on two different approaches that Kansas is taking to deal with a looming federal requirement to set up a statewide insurance marketplace by 2014. Some say the exchange will help an estimated one in eight Kansans without a health plan find affordable coverage.
The marketplace requirement is a critical part of the federal Patient Protection and Affordable Care Act.
Proponents say requiring everyone, including those who are healthy, to buy some form of health coverage is crucial to making the plan work and keeping costs in check. Opponents, including Kansas and 25 other states suing to block that requirement, contend those requirements are unconstitutional. Both sides agree that the U.S. Supreme Court will need to settle that question.
In the meantime, all states, including Kansas, are under a federal deadline to have such a marketplace up and running by Jan. 1, 2014, or accept one that the federal government says it will develop before then. Meeting that deadline in Kansas will require legislators to approve broad outlines before June in order to build and test the market during 2013.
Getting that much work done that quickly is highly unlikely, said state Rep. Susan Mosier, R.-Manhattan, a member of the Legislature’s Joint Committee on Health Policy Oversight, which is exploring the problems.
Mosier, who is an ophthalmologist, said her own experience with such projects leads her to believe that the federal deadlines, originally set in 2009, now leave too little time to accomplish the federal act’s goals.
“I don’t even think the federal exchange can be completed in that time,” Mosier said. “We’re a year behind already.”
Some preliminary work, which started in January in Kansas by more than 70 insurance and tech company executives, public policy specialists and other volunteers assembled by Kansas Insurance Commissioner Sandy Praeger hit a snag when the state announced it was returning a $32-million federal grant that had been awarded to pay for that early work.
That federal money, awarded specifically to help Kansas pay for front-end high-tech work, came with too many strings attached, said Lt. Gov. Jeff Colyer, a surgeon who serves as the administration’s point man on medical policy.
Kansas is one of 26 states challenging the constitutionality of requiring consumers to buy health insurance, Colyer said to legislators last week. Three different federal appeals courts have ruled three different ways in lawsuits seeking to overturn the requirement. That almost certainly means the U.S. Supreme Court will make the final decision, he said.
“We are not building an exchange until the Supreme Court has ruled,” Colyer said.
Praeger, meanwhile, said the volunteers she’s been coordinating plan to continue their work on a reduced scale and do as much as they can to offer the next Legislature plans for an insurance exchange.
“Until such time as there is a change in the law, I feel a duty to continue to prepare for full implementation of all the requirements,” she said.
What states give up if they don’t create an exchange by the deadline isn’t clear, said Manny Munson-Regala, vice president for strategy and government partnership at Ceridian Corp., a global benefits consulting firm based in Minneapolis.
“We don’t know what the federal plan is,” Munson-Regala said. “They’re behind schedule too. But at the very least, the longer states wait, the more flexibility they are likely to lose in picking an exchange that is right for them.
“It’s like buying a car,” he said. “If you have a little time, you can go into the dealer and order exactly the options you want. Or you can buy what’s on the lot if you need one right away.”
Few Kansas government or insurance industry executives involved in the early design work for a homegrown statewide health insurance exchange say they want to buy off the lot.
“We believe there will be a better outcome with a program that is designed in Kansas and run by Kansans,” said Mary Beth Chambers, corporate communications manager for Blue Cross/Blue Shield of Kansas Inc., the state’s largest health insurance provider.
“Otherwise, we worry that we’ll go into a one-size-fits-all federal plan that won’t recognize the nuances that exist in Kansas,” Chambers said.
Until then, said Gina Ochsner, president of the Century Health Solutions Inc., an insurance and employee-benefits brokerage firm in Topeka, “We’re just as confused as everyone else. We don’t know what legislation is going to pass.”