A Compact on America

The quality and availability of health care is among the most important aspects of our lives, both for us as individuals, and for the people who depend on us: our aging parents and our children. And as a result, it is a critical issue in politics, and specifically at issue in the upcoming elections on November 4.

First, a failed Medicaid alternative

In late 2011, Governor Sam Brownback announced reforms to how the neediest Kansans, formerly under Federal Medicaid, would receive health care. Remember, Medicaid is a Federal and state program to provide health care for people who cannot afford it on their own, or are disabled. This new program, KanCare, was implemented on January 1, 2013 with three insurance partners, and 380,000 Kansans previously receiving Medicaid were pre-enrolled in one of the three plans.

How has that turned out? KanCare has failed almost everyone involved. In reports and newspaper articles, it is clear that the insurance companies have seen dramatic losses (over $110 million the first year, $76 million so far the second year), the health care providers have seen late reimbursements (a 130% increase in payments 90 days past due) and lower actual payments (a planned 9% increase turned out to be a 6% decrease), and patients have seen an increase in coverage denials. Mentally disabled individuals, previously covered under Medicaid, had to fight to finally get included under KanCare.

Add to this the Brownback Administration's petulant refusal to take $350 million in Federal funds for expanding Medicaid, and you have a managed care plan that has not managed to keep Kansans healthy.

Next, a Medicare takeover

Now, Brownback and his cronies on the far right plan to do it again, this time with Medicare. In the last session of the Kansas Legislature, his allies passed a measure for Kansas to join the Health Care Compact. This is a special-interest-fueled scheme to remove the Federal government from Medicare, instead taking the money and having each state in the Compact manage their own care for those citizens over 65 years of age.

Because they've done such a good job with the poor and disabled.

Even the Republican Kansas Commissioner of Insurance warned against the Compact in this letter (.pdf) in February of this year.

All this came to a head in Johnson County last week, when some conservatives got wind of an article planned for this month's Best Times, a publication of the County's Area Agency on Aging. The article was critical of the Compact, urging lawmakers to reconsider it. Their strongest concerns: KanCare's poor record, and the state's financial extremity. Could the agencies and entities barely making KanCare work, effectively manage Medicare? With all Federal Medicaid and Medicare dollars coming to the state in a lump sum, how would it be distributed fairly in a revenue-starved government? We have already seen the Brownback Administration taking money from transportation budgets to cover education expenses, and lumping retirement benefits into education as "more public school funding." There is no confidence that the state could make anything but another mess of this.

The Best Times article sparked a firestorm among conservative lawmakers. First they demanded a meeting with the Commission on Aging, authors of the article. At this meeting they first cajoled, then argued, and finally bullied the Commission in an attempt to get them to retract the content. The Commission stood firm. The media got wind, and took the lawmakers to task for their trenchant bullying, and they backed off. But they insisted on publishing their own rebuttal in the Best Times.

These are the stakes

The Kansas Legislature, controlled in both House and Senate by extremist legislators willing to do what they are told by the Brownback Administration, have shown time and again that they will make law without regard to consequences. Budgets, they believe, will work themselves out. Revenue fairies will swoop in and grant them so much money they don't need to collect taxes.

But we don't live in that fantasy world. Neither do the children and parents we care for. There is a great opportunity in this election on November 4 to take back some of the sensible, even-keeled ground that has been lost over the last few years.

Get informedGet involved. Do more than vote.

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