My, the bloom fades fast.
No sooner had many Kansans celebrated the validation of the Affordable Care Act by the U.S. Supreme Court, than our governor Sam Brownback said it was all for naught.
As a state, we’ll ignore the federal law, he said, gambling that Mitt Romney will become our next president and wipe the slate clean.
For the record, Brownback’s forecasting skills aren’t so hot.
FANS CALLED Thursday’s ruling a hallelujah moment for American families.
Opponents predicted doomsday for the country.
Could we really be that far apart on how best to provide health care?
The ruling puts the United States, finally, in league with the other industrialized nations of the world by providing health care for all, no matter their sickness, their income, their age.
The ruling broadens access to health care. No longer can health insurance companies cherry-pick the people they cover.
Now, senior citizens can’t be “maxed out” by an insurance company because of a chronic illness. All Americans, not just children, can receive health insurance if they have a pre-existing illness. Poor people who are single or childless, not just those with families, will receive health insurance.
THURSDAY’S ruling was not an unqualified success. The decision allows states to “opt out” of expanded Medicaid coverage with no fear of losing their current funding for Medicaid programs. As one of the 26 states that pledged itself against “Obamacare,” Kansas could see the bruised egos of its governor and legislators get in the way of common sense and shirk its moral responsibility to lower-income families and opt out. If it does, it will lose multi-millions in additional federal funding that would have covered newly eligible residents up to 133 percent of poverty level, the equivalent of about $30,656 for a family of four.
Under the provision, the federal government will be extremely generous. Between 2014 and 2016 the federal government will pay 100 percent of the Medicaid expansion; in 2017 it will cover 95 percent, with it slowly declining to 90 percent by 2020 and remain there.
There’s not a hospital or health care facility in Kansas that would favor a state decision to reject the Medicaid expansion. Every year, Allen County Hospital writes off more than $1 million in bad debts, because of people unable to pay their bills. Having a broader base of insured patients is money to a hospital’s bottom line. No, Medicaid reimbursements don’t meet costs, but any amount of compensation is better than none.
KANSAS ALSO could find itself in trouble if it ignores the Supreme Court’s ruling until November — as if the election could somehow reverse the law’s provisions.
Even if Mitt Romney is elected, the course, in essence, was determined in 2010 when Congress passed the health care act. For much of the legislation there’s no turning back.
Over the past two years many states have been working on devising their own health insurance exchanges, which take effect January 2014.
The premise is that each state can develop its own “market place” of insurance programs from which consumers can shop. The first deadline is Nov. 16 for a review of each state’s programs. If a state fails to meet the required criteria for implementation, then it will fall under the federal government’s umbrella of exchanges.
If memory serves correctly, Kansas was at the forefront of developing its exchange system when Brownback pulled the plug and insisted that Insurance Commissioner Sandy Praeger return the $31.5 million federal grant awarded to the state to help with the computer infrastructure necessary for the program.
Brownback’s gamble that the Supreme Court would negate the health care act most likely has set Kansas too far back to establish its own exchange system. To gamble again that Republicans will take control in Congress and the White House in November and enact a blanket waiver from the requirement to have exchanges, could put the state even further behind.
It’s far more prudent to be proactive, than reactive.
The ideological decisions by Brownback and ultra-conservative members of the Legislature to ignore federal law does nothing but damage our state’s chances to make more of its own health care decisions.
Too bad we couldn’t see that in the cards when we voted them in.
— Susan Lynn