A recent article published by Kansas Health Institute said Senator Jim Barnett (R-Emporia) was ahead of the curve regarding the creation of a health insurance exchange in Kansas back in 2007, pointing out that his proposal was similar to the Obamacare initiative now rejected by conservative groups, and was supported by some conservative health care reformers at the time.
As someone who was on the ground working in the reform arena, pushing a much different alternative to the connector plan, the article’s premise regarding conservatives’ current take on health care reform strikes me as a bit of “gotcha journalism”:
■ conservatives oppose Obamacare because it creates a mandated health insurance exchange;
■ but in 2007, Jim Barnett supported such an idea in Kansas, and he was supported by some conservatives from Washington.
■ Therefore, conservatives really oppose the current idea because they dislike Obama.
The article represents a striking misunderstanding about the debate at that time on the Right regarding health care reform. Let me set the record straight.
In 2007 the idea of reforming health care was galvanizing a variety of interest groups and think tanks at the state level. The Kansas Health Policy Authority had been created as a policy warehouse to promote different ideas regarding the best reforms for Kansas. It became clear that the only considerations the KHPA would hear would be those which supported the extension of government-run programs. Barnett and other Republicans helped create KHPA but their actions were certainly not representative of those who prefer consumer-driven reforms.
Kansas Policy Institute sought allies outside of the KHPA to promote consumer-driven reforms, such as more use of Health Savings Accounts, including HSAs for state Medicaid recipients. KPI brought in Michael Bond, a health economist affiliated with the James Madison Institute, to testify about such policies before House committees and before the KHPA. We worked with House members, specifically Reps. Jeff Colyer (R-Overland Park), Peggy Mast (R-Emporia) and Brenda Landwehr (R-Wichita), to promote our ideas in testimony and through policy papers. Colyer, a physician himself, promoted a series of policies, some of which were included in the final Senate Bill 309, which failed to pass the legislature.
Moreover, CATO Institute health care scholars Michael Tanner and Michael Cannon also testified before House committees on consumer-driven reforms. In each case they warned against a connector model similar to the one in Massachusetts that has failed to reduce health care costs.
There was a distinct difference of opinion on the Right about how to promote health care reform. On one side stood those who thought—incorrectly as it turned out—that one could promote insurance coverage through a health care connector while reducing costs of care. On the other stood those who focused on costs alone—reducing health care costs through consumer-driven options such as HSAs (even for Medicaid recipients—Indiana has tried this successfully through its Healthy Indiana Program). If you reduce the costs of insurance, more of the uninsured would purchase the products, increasing the health of the private insurance market while preserving Medicaid for the poor and disabled. This has worked in Indiana but Obamacare might destroy its progress.
The conservative view of health care is more variegated than portrayed by the KHI article. Not everyone on the Right thought the connector was a good idea, and most everyone thinks it is still bad policy. That has been a consistent view among many on the Right since Massachusetts passed its plan in 2006. One can clearly see the failure in Massachusetts now (it recently had to borrow money from the federal stimulus program to plug budget holes created by its Connector reforms). Some on the Right saw it then and have consistently warned against the adoption of such schemes on the federal level.
Gregory L. Schneider, Ph.D., is senior fellow at Kansas Policy Institute and professor of history at Emporia State University.