By Mike Shields
KHI News Service
TOPEKA, Feb. 19
Aiming to set the course for the Legislature”s health-care debate this year, the
Health for All Kansans Steering Committee
is scheduled to begin today sifting its way through about 30 health-care proposals.
The committee, in the wake of Gov. Kathleen Sebelius” surprise call for a universal health-care plan at the beginning of the session, has been instructed to decide the best among the plans as it prepares recommendations the Legislature could act upon this year.
The ideas range from sweeping to tentative and also are in various stages of gestation.
In the committee”s stack
is Sen. Jim Barnett”s
Senate Bill 309
,
which would create an insurance exchange or connector similar to the one used in Massachusetts. The bill would require that everyone participate in the plan or post $10,000 in escrow, but is still silent on issues that many connector supporters consider essential, namely a subsidy for low-income Kansans so they can afford to use the exchange. In Massachusetts, the connector subsidizes individuals and families who have income 300 percent of federal poverty guidelines or less. That means a single person with annual income up to almost $30,000 can qualify for state assistance.
Deciding what, if any, level of subsidy might be required is likely to be contentious. The bill already has some lawmakers wary because it includes the requirement that all individuals participate. House Speaker Melvin Neufeld, R-Ingalls, has repeatedly expressed his opposition to such mandates, though he has said he likes the idea of a connector minus mandates.
Also, other legislators newer to the issue were listening earlier this week when Cato Institute health policy expert Michael Tanner cautioned them against mimicking Massachusetts.
“The individual mandate is an unprecedented expansion of government power and intrusion into the American health care system,” Tanner said.
He spoke to at least two committees and said he met privately with House GOP leaders and separately with staff from the governor”s office.
He said the House leaders “seemed quite sympathetic” to his views.
Tanner told lawmakers they should step back and wait for the federal government to deal with the problem of the uninsured.
Meanwhile, last week, the House Insurance and Financial Institutions Committee heard the favorite plan of House Democrats,
HB 2172
. The bill would create a pilot program allowing 1,000 small-business workers to join the state employee health plan. The bill met opposition from insurance agents and other insurance interests but was endorsed by small businesses and their advocates.
House Minority Leader Dennis McKinney, D-Greensburg, on Friday said lawmakers should not let grand plans put on hold more limited “doable” things such as the
Democrats” bills
.
“These are measured bites of the apple that make meaningful improvements for maybe thousands of Kansans,” McKinney said. “These are market-oriented solutions that help small business. I think most people would say these are Republican ideas. Every time we try to work on health care we”re told to wait until next year for something big”
That plan, or something much like it, is included on the list that the steering committee begins sorting on Monday, the same day that the Senate Public Health and Welfare Committee is scheduled to begin two days of hearings on Barnett”s bill.
It also was clear last week that many lawmakers, if not most, are waiting to see what various committees and task forces kick out before paying much attention to the health- care debate.
Senate Minority Leader Anthony Hensley, D-Topeka, said his caucus has yet to be briefed on
SB 309
by Sens. Laura Kelly, D-Topeka, or David Haley, D-Kansas City, though that might happen soon. Kelly and Haley are the Democrats on the Senate health task force appointed when the session started.
Hensley said he thought the plan most likely to clear the Legislature this year is Gov. Kathleen Sebelius” push to expand insurance to about 2,000 more children by stretching HealthWave eligibility. The plan”s estimated cost is $10 million for the coming fiscal year, $6 million of that from the federal government.
“I think Barnett might be swimming upstream in his own caucus,” Hensley said, “but I would think at a minimum we”d be able to do the governor”s zero-to-five proposal.”
On Friday,
Sebelius said her recent discussions with Secretary of Health and Human Service Mike Leavitt, raised more questions than answers about what the Bush administration might do to follow through on the president”s state-of-the-union pledge to help states craft innovative approaches to helping the uninsured.
“I keep asking if there will be new resources, if he”ll bring a checkbook to the table,” Sebelius said, noting that the Bush budget was lean on dollars for programs
The governor said Leavitt was receptive to Kansas efforts to increase medical cost transparency and increase and streamline data collection, but was less willing to talk about the possibility of new federal dollars.
“It”s a very mixed signal,” she said.
There are transparency and data collection initiatives included among the list the steering committee tackles Monday.
The committee will meet from 12:30 p.m. to 2 p.m. at the Eisenhower State Office Building, 700 Harrison, 4th floor, west wing, conference room B.
Mike Shields is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
mshields@khi.org
or at 785-233-5443, ext. 123.