A health care compact bill designed to get Kansas and other states out of federal health regulations is gaining attention locally for its possible Medicare implications, but a national expert on Medicare says the compact, which would need congressional approval, is not even being discussed in Washington, D.C.
Tricia Neuman, a senior vice president of the Kaiser Family Foundation and director of the foundation’s Program on Medicare Policy, says she has read news reports of the compact that nine states have joined, but as far as she knows “there’s no discussion of congressional action on the compact,” which would allow states to receive their Medicaid and Medicare money in no-strings-attached block grants.
“The idea of Medicare block grants is not something that has reached the front burner, or even the back burner, in Congress,” she says.
Neuman is scheduled to give the keynote address at 9 a.m. Tuesday at the Sunflower Fair in Salina’s Bicentennial Center. The fair, sponsored by the North Central-Flint Hills Area Agency on Aging, is an all-day exhibition for seniors and their caregivers.
Julie Govert Walter, executive director of the North Central-Flint Hills Area Agency on Aging, calls Medicare a “national treasure” and says her organization is delighted that Neuman agreed to speak about it.
“Dr. Neuman, a nationally recognized expert from one of our country's most respected foundations, is devoted to knowing Medicare and in her presentation will answer questions people have about Medicare,” Walter says.
Neuman's visit occurs as the Kansas Legislature’s vote to join the interstate health care compact comes under increasing scrutiny. The Johnson County Commission on Aging plans to run an article next month in a county newsletter called The Best Times criticizing the vote for its possible Medicare implications. Conservative Republican legislators who spearheaded the compact's passage as a repudiation of President Barack Obama's health reforms have called the draft of the article unfair and tried to have it altered prior to publication.
The Johnson County League of Women Voters is devoting its Sept. 30 “JoCo in the Know” forum to the health care compact, and promoting the event with fliers that ask: "Have you heard about a new law called the Health Care Compact? Are you concerned that it might change your Medicare?"
Kansas Insurance Commissioner Sandy Praeger and the retiree group AARP cited Medicare concerns when they testified against the compact bill last session.
Linda Sheppard, former special counsel and director of health care policy and analysis for the Kansas Insurance Department and now with the Kansas Health Institute, is slated to be on a panel at the League of Women Voters event. The Kansas Health Institute is a nonpartisan policy and research organization that also houses the editorially independent KHI News Service.
Neuman says that if Medicare is included in the compact, “then it does raise some questions that I’m sure seniors would want to have answered.”
Block grants are capped payments, she says, whereas Medicare as it is now administered by the federal government is an entitlement program to specific services regardless of costs. So seniors would want to know if they would still be entitled to those same services if the block grant payments from the federal government don't keep pace with the costs, Neuman says.
“Those are typically the questions people ask when there’s discussion about a block grant,” Neuman says. “A block grant differs from an entitlement because the dollars are fixed, which raises questions about whether or not the same sort of benefits are promised.”
Legislators who supported the compact have said that the state would not touch the Medicare program under the compact or that it would only take it over to save it from a federal government deep in debt.
Though the Legislature and Gov. Sam Brownback approved Kansas' membership in the compact, its effects remain purely hypothetical for now.
Rep. Tim Huelskamp, a Kansas Republican, has co-sponsored a compact approval bill, but it has gained little traction at the federal level thus far.
In vetoing the compact in his state, Montana Gov. Brian Schweitzer said the United States will “put a person on Neptune”before Congress OKs the compact. Some constitutional scholars say the president also has to approve interstate compacts before they take effect, though the Competitive Governance Action group that drafted the health care compact disputes that.
The compact was adopted as model legislation by the American Legislative Exchange Council, a conservative, business-backed group, in 2011, helping it gain approval in South Carolina, Georgia, Indiana, Alabama, Texas, Utah, Oklahoma and Missouri, as well as Kansas.
