A bill that seeks to remove Kansas from the Affordable Care Act — if Congress approves — passed the House on Monday.
House Bill 2553, which passed 74-48, commits Kansas to join a health care compact, a hypothetical network of states that would be allowed to set up their own health insurance regulations separate from the Affordable Care Act. It now goes to the Senate.
The legislation was drafted by Competitive Governance Action, a Houston-based organization, and sponsored in Kansas by Rep. Brett Hildabrand, R-Shawnee. The bill hinges on a clause in the U.S. Constitution that gives Congress the authority to approve interstate agreements known as compacts.
Presidential approval is not needed.
It’s unlikely that such a plan would be approved by the U.S. Senate while Democrats are in the majority. But Hildabrand said this theoretical compact becomes a practical option if Republicans take control of the Senate.
“I think this is much more than a symbolic action,” Hildabrand said a few minutes before the House took its final vote. He added that this is one of several possible escape routes from the Affordable Care Act. “My personal viewpoint is, why not try them all and see what sticks.”
Some opponents dismiss the bill as a piece of political theater. But others, like Kansas Insurance Commissioner Sandy Praeger, worry that it could have real and damaging consequences.
States in the compact would still receive the same federal dollars for healthcare, but would be able to set their own regulations and determine how to use that money. Opponents say this could affect Medicare recipients in Kansas in addition to lifting Affordable Care Act regulations.
Praeger said this means insurance dollars could be misused on other areas of the budget.
“I understand the politics of removing the state from the Affordable Care Act, but the compact has implications that go beyond the ACA,” Praeger said in a statement. “Most notably, it changes the oversight of the Medicare program for seniors and includes those Medicare dollars with Medicaid and other health care dollars coming to Kansas in a lump sum.”
Hildabrand disputes her reading.
“The bill explicitly says the money has to be spent on healthcare in Kansas,” Hildabrand said.
Republicans who voted against the bill were concerned about the potential impact on Medicare.
“I had to choose. I chose Seniors over politics,” Rep. Stephanie Clayton, R-Overland Park, tweeted seconds after the bill’s passage to explain her no vote.
Rep. Don Schroeder, R-Hesston, said that in voting to drop federal healthcare policy, the Legislature was voting to increase the size of state government.
“While I understand the issue of state sovereignty, House Bill 2553 if enacted has a high price to pay. Administrative programs for Medicare and the healthcare exchange that are not accounted for in the bill. These programs would increase the size and scope of state governments,” Schroeder wrote in his vote explanation.
Hildabrand said the bill would allow Kansas to return to the healthcare system that existed before the Affordable Care Act. He said a “free market approach” would benefit seniors and business owners alike.
“I think that some of the regulations that Obamacare places have been detrimental to both our seniors and our business owners, particularly our small business owners. So for one, I’d like to see us reset the clock on that and go pre-Obamacare,” he said.