under the federal health care overhaul. The 26-year-old Lenexa resident said he’s uninsured, hurt his back this summer and ran up almost $16,000 in medical bills in 10 days.
He joined about 250 people on the University of Kansas’ satellite campus in the Kansas City area for one of 11 events this month led by Insurance Commissioner Sandy Praeger ahead of Tuesday’s opening in each state of online marketplaces known as exchanges. Praeger’s office brought stacks of brochures and showed off its website for helping consumers during a session lasting two hours.
But Praeger was forced to scrap plans for a $10 million campaign with television and billboard advertising because the conservative Republicans who control state government strongly oppose the 2010 federal Affordable Care Act championed by President Barack Obama. GOP conservatives view the Democratic president’s signature domestic initiative as burdensome and deeply flawed.
GOP conservatives gained their clout in Topeka by attacking “Obamacare” in election campaigns. Responses to it from the Legislature and Gov. Sam Brownback’s administration reflect their belief that Kansans overwhelmingly want to steer clear of the overhaul.
But as a result, Praeger and some advocates for the uninsured said they'll be relying heavily on word of mouth to inform people about changes wrought by the law. Stagner doesn’t believe the state is reaching enough people.
“Between all the bickering back and forth on both sides, they’ve lost focus on what’s important,” he said of the state’s political leaders.
Under the federal law, enrollment in plans offered through state exchanges opens Oct. 1 and runs through March 2014, though people must enroll by Dec. 15 if their coverage is to start at the beginning of the year. The federal law promises subsidies.
Most Americans will face paying an additional tax, starting next year, if they don’t have health coverage. The law phases out annual and lifetime limits on expenses covered by health insurance, and it prohibits people from being denied coverage for pre-existing medical conditions.
Many Republicans argue that its provisions and the attendant federal regulations will drive up premiums and discourage employers from offering coverage. Senate Public Health and Welfare Committee Chairwoman Mary Pilcher-Cook said the state should help people buy coverage they want outside the exchange at prices low enough that they'll come out ahead.
“Why would you want to educate Kansas citizens to become part of a policy that’s going to cost them more money and give them less choice on their health care?” said Pilcher-Cook, a Shawnee Republican.
Blue Cross and Blue Shield of Kansas, the state’s largest health insurance company, has scheduled 14 public town hall meetings on the overhaul in October and November. The company will be offering coverage on the Kansas exchange, and spokeswoman Mary Beth Chambers said many consumers probably will become more engaged after enrollment starts.
“Because so much of the dialogue around the Affordable Care Act and health care reform has been politicized, some of the consumers have just tuned out,” she said.
Praeger, a GOP moderate, is rare among Kansas Republicans describing the law as an important step toward universal health coverage instead of criticizing it harshly. But she’s not planning to run for re-election next year and has acknowledged that her stance probably would prevent her from winning the Republican nomination anyway.
In 2011, Brownback’s administration returned a $31.5 million federal grant for setting up the computer infrastructure within Kansas for the state’s online insurance marketplace. In 2012, Brownback decided against having the state partner with the federal government on the Kansas exchange.
Praeger’s plans for a $10 million public education campaign depended upon the $31.5 million federal grant that Brownback’s administration returned. Praeger said in an interview that her department pulled together a little less than $1.4 million for education and other work on the exchange.
“We have 50 million Americans that don’t have health insurance, and if you don’t have health insurance, you don’t have a medical home,” Praeger said.
The day after Praeger’s health care meeting in Overland Park, Lt. Gov. Jeff Colyer testified before a congressional subcommittee in Washington, urging repeal of the overhaul.
Colyer is a reconstructive plastic surgeon and frequently the public face of Republican Gov. Sam Brownback’s administration on health care issues. He testified that states are struggling with technical issues associated with the federal government’s implementation and added that the law’s mandates will discourage growth among small businesses.
“A lot of this stuff isn’t ready for prime time,” Colyer said in an interview afterward. “I can’t blame people for being confused.”
Colyer said consumers already could find competitive health insurance rates and more choices in private, online health insurance markets. While the Insurance Department has approved 72 plans for sale on the exchange, in most of the state, only two companies will be involved in offering them.
Michelle Mergenthaler, a 30-year-old nurse from Overland Park, said she’s worried that some people still won’t be able to afford plans offered on the exchange. She said young adults may not buy insurance as a result and could “be left out in the cold” when tax penalties escalate in future years.
As for educating the public, she said, “It’s going to be a slow process.”