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Debate On Health Care Compact Article Heats Up

Tension built Monday as legislators who supported a health care compact bill that would free Kansas from federal health care regulations made a last ditch-effort to pressure a Johnson County advisory board not to publish an article critical of the compact in a county newsletter.

After Sen. Mary Pilcher-Cook, a Shawnee Republican, expressed concerns at a legislative breakfast last week about the forthcoming article, the Johnson County Commission on Aging invited her to have a follow-up meeting on the issue. Pilcher-Cook returned on Monday flanked by 10 other Republican lawmakers, including House Speaker Ray Merrick of Stilwell.

The legislators present called the article, scheduled for publication in Johnson County's The Best Times magazine, “reckless,” “dishonest,” “irresponsible,” “partisan” and “misleading.”

“I think you have taken a huge jump, a reckless jump, with the article you intend to publish in The Best Times,” Pilcher-Cook said.

All the legislators who attended Monday's meeting are conservative Republicans who helped pass House Bill 2553 as a repudiation of federal health care changes spearheaded by President Barack Obama. They said the proposed article unfairly predicts changes to Medicare as a result of the bill in a blatant attempt to scare seniors.

Members of the commission on aging defended their work, saying they understood the compact well and remain concerned about its potential effect on Medicare, the federal program that provides health coverage to the elderly and some disabled citizens, including about 450,000 Kansans.

“We did our due diligence too,” chairwoman Patti Rule said. “We didn’t immediately put out just a knee-jerk (response).”

Following the meeting, commission on aging leaders said they may tweak the headline to appease the legislators but don’t otherwise intend to change the content of the article. They said a demand that the legislators be allowed to run their own concurrent article about the compact was outside their authority.

The Johnson County Commission assumed publication duties of The Best Times last year, but the pages allotted to the commission on aging are provided through federal dollars from the Older Americans Act.

Future implications?

The commission on aging is a group of eight volunteer advocates who advise the Johnson County Area Agency on Aging. They are appointed by Johnson County commissioners.

Sen. Jim Denning, a Republican from Overland Park, said that publishing the article would anger many area legislators.

“You really need to think about this because one of your objectives is to have a good working relationship with the Johnson County legislative delegation,” Denning said.

During the meeting, Merrick sat off to the side of the conference table next to Dan Goodman, director of the Johnson County Area Agency on Aging.

At one point, Merrick turned to Goodman and said, “This is going to set you guys back.”

Goodman did not respond.

Merrick declined to explain the comment after the meeting.

When asked how he interpreted it, Goodman said, “I don't know how I should take it.” He said his agency receives some state funding to operate an Aging and Disability Resource Center.

When told what Merrick said, Rep. Jim Ward, a Democrat from Wichita who was not at the meeting, said it sounded like a threat.

“This is typical behavior,” Ward said. "Call your opponents names and threaten them. They cannot win the debate on ideas.”

Nine states have signed the health care compact, which petitions the federal government to release them from health care regulations and would allow them to receive the money currently spent on federal health programs like Medicare and Medicaid as block grants.

Proponents said it would liberate Kansas from the mandates of the Affordable Care Act, commonly known as Obamacare. Kansas Insurance Commissioner Sandy Praeger and the retiree group AARP testified against the bill, saying it posed a threat to Medicare.

The commission on aging's article focuses on opposition to the compact's potential to turn Medicare over to the state.

Praeger, in a phone interview Monday, said it is a legitimate concern.

“They have a very serious concern, and I think it’s very appropriate that they raise those concerns, as did AARP, as did several other groups,” Praeger said. “This has kind of flown under the radar, and I think it’s great that it’s finally getting some attention.”

When the bill came to the House floor, Ward offered an amendment to take Medicare out of it, but it failed 57-61.

Rep. Keith Esau, a Republican from Olathe who supported the compact, said the Legislature couldn’t amend the bill because all of the states joining the compact were attempting to approve the same version.

The House passed the compact 74-48 without Ward's amendment, the Senate passed it 29-11 and Gov. Sam Brownback signed it April 22.

Congress must approve the compact before it goes into effect, but constitutional scholars also say the president would need to approve it.

In signing it, Brownback said he would oppose any cuts to Medicare.

Downplaying Medicare concerns

Some legislators sought to assure the commission on aging members Monday that the state had no interest in touching Medicare. But others said the compact could provide a safety net if the state needs to save Medicare from the federal government. Rep. Jerry Lunn, a Republican from Overland Park, said he believed that rising federal debt made a state takeover of the program almost inevitable.

“Does anybody believe that the federal government is not going to make wholesale, major cuts to all programs?” Lunn asked. “This would be included. We’re trying to do something to get out ahead of that because this is going to come back to the states to try to manage and fix this mess.”

Peg Deaton, a member of the commission on aging, said she opposed the compact in part because the state doesn’t have a plan for administering the massive federal program. She said she had heard little practical information in general on the compact, including how the state would pay for an advisory commission, mandated by the compact, to make recommendations to member states.

“It has to be funded by the states that are members of the compact,” Deaton said. “How much money are we talking about?”

“It could be minuscule, because they could teleconference,” Pilcher-Cook said.

“And it could be millions,” Deaton said. “Where is that money coming from?”

Eugene Lipscomb, vice chairman of the commission on aging, asked why legislators had not done more to educate seniors about the compact, saying that most people he had talked with had not even heard of it.

“How come you hadn’t talked to them before you wrote it, before you signed it?” Lipscomb said.

Sen. Jeff Melcher, a Leawood Republican, said the commission on aging should have done that.

“You should be watching legislation that’s important to you and participating in the development of it,” Melcher said. “But to ignore it and abdicate your responsibility and then to come back at the eleventh hour and drop an October surprise is partisan and it’s disingenuous.”

Other legislators echoed Melcher's complaints about the timing of the article, which will be published in October, one month before the general election for all House seats and statewide offices, including governor.

Three Republican senators and about a dozen Republican House members crossed party lines to vote against the compact, deepening a divide between moderate Republicans like Praeger and conservatives who gained control of both chambers and other statewide offices in part by making their opposition to Obamacare a centerpiece of the last two election cycles.

'Right for seniors'

Chuck Nigro, chairman of the commission on aging's legislative committee, said the timing was a function of how long it took for the commission to study the compact bill, write the article and prepare it for publication. Nigro said the commission is nonpartisan.

“Our intent was not to have a big fight over this,” Nigro said after the meeting. “Our intent was just to do what we think is right for seniors.”

Sen. Molly Baumgardner, a Republican from Overland Park who was appointed after the compact was approved, said that regardless of the commission on aging's intent, the article will be used by Brownback's Democratic opponent, Paul Davis.

“The minute it is printed and distributed, you have published campaign material and get ready to see it in the television advertising and mailers and emails across the state, I guarantee it,” Baumgardner said. "You will be used. I don’t think that’s your intent, but you will be used.”

Baumgardner asked the commission on aging members to consider how that might reflect on the county commissioners who chose them.

“I know that you are not here necessarily from a political standpoint, but keep in mind why are you here and how are you here,” Baumgardner said. “You are appointed.”

After the meeting Deaton said she had been appointed and reappointed by several different county commissioners during her eight years on the commission on aging.

“I've got two years more to go, and nobody can fire me,” Deaton said.

Andy Marso is a reporter for KCUR 89.3 and the Kansas News Service based in Topeka.
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