Barbara Shelly

Inside the feud over the Kansas health care compact law

Kansas is on the road to eliminating the Medicare program as residents know it. But it’s a long road with plenty of off ramps.
Kansas is on the road to eliminating the Medicare program as residents know it. But it’s a long road with plenty of off ramps. The Associated Press

Never has an issue of The Best Times, Johnson County’s monthly magazine for seniors, been so eagerly awaited. I know I’ve been on the edge of my seat.

At first the draw was to read the article that had gotten some Kansas legislators so worked up that 11 of them stormed en masse into a meeting to berate the volunteer members of the Johnson County Commission on Aging for writing it.

The Legislature last session passed a bill potentially enabling Kansas to shuck off Obamacare and other regulation-laden federal programs and join other states in a “health care compact.” Naturally, lawmakers would expect federal money to do this. Gov. Sam Brownback signed the bill.

Members of the Commission on Aging, who advise county leaders, looked at the new law and found it alarming. They penned their concerns in an article for the October edition of The Best Times.

Perhaps it was the headline, “State of Kansas on road to eliminating Medicare,” that sent the conservative Republican lawmakers into a tizzy. They demanded the commission pull the article.

The commissioners politely refused. They did agree to tweak the headline.

On Wednesday, The Best Times emerged in print and on line. Page 7 contains the awaited article, now headlined “Kansas on the road to eliminating Medicare?”

The answer is yes, maybe. Kansas is on the road to eliminating the Medicare program as residents know it. But it’s a long road with plenty of off ramps.

The article expresses concern about the proposed compact and asks some pertinent questions: Could health care funds be diverted toward other purposes in tough budget years? What expertise does Kansas have to manage a health care program for older people? What would happen to Kansas seniors who leave the state?

Excellent questions. But there’s more!

Johnson County officials, lacking the fortitude of the Commission on Aging members, agreed to print a rebuttal article. Signed by 23 lawmakers, it appears on page 8 of The Best Times.

If the commission’s original headline was a stretch, the legislators’ summary is ludicrous. It reads: “Kansas Legislature Saves Medicare with innovative Obamacare fix.”

The rebuttal takes some space to reassure seniors that this whole compact thing may never happen. It has to be approved by the U.S. Congress, and then the state Legislature would have to pass another bill.

But if it does happen, seniors should be glad, according to the rebutting lawmakers. They repeat an old and erroneous claim that the Affordable Care Act strips $716 billion out of the Medicare program.

This is misleading. The federal health care law does not take money out of Medicare but seeks to hold down future health care costs by reducing the costly Medicare Advantage program.

The legislators make no attempt to answer the commission’s questions. But they assure readers that the health care compact would enable Kansas to get rid of the reviled individual mandate and employer mandate. Insurers would flock to the state and Kansas could even become a destination for health care tourism. (Get your hip replaced in beautiful Topeka, folks.)

“Under no circumstance do we want to change Medicare or the benefits Kansas seniors enjoy under Medicare,” the lawmakers wrote.

But of course Medicare would change with a state bureaucracy running it. Based on what the Brownback administration has done with Medicaid, contracting the program to for-profit managed care companies must be considered a possibility.

The Best Times really should run a rebuttal to the rebuttal, but I sense that county leaders are ready for this flap to end. Commission on Aging members deserve a round of applause for starting it. As they said about the compact, “This is bad legislation and it is bad for Kansas Medicare recipients.”

Reach Barbara Shelly at 816-234-4594 or Twitter: @bshelly.