Kansas Insurance Commissioner Sandy Praeger believes there are too many good things in the Affordable Care Act to be overturned by the court system or Congress after the presidential election.
“I think it will be very hard to overturn the law,” she said. “When you really pin people down, there are lots of aspects of this law that people like.”
• Elimination of annual and lifetime limits on insurance coverage. She said often those who need insurance coverage the most can’t get it, and that’s why so many Americans end up in bankruptcy. She said medical care is the No. 1 reason for U.S. bankruptcy.
• Elimination of pre-existing medical conditions. People will no longer be denied insurance coverage because of illness or previous health conditions. “Today, you most likely wouldn’t get coverage if you’ve had cancer. You would be denied,” she said.
• No co-pays or deductibles on preventive services, such as annual wellness exams. “Early detection of a disease or problem can be cost-effective, and the outcomes are often better. It’s a win-win,” she said.
• Allowing children to stay on their health insurance plan until age 26. She said about 2.5 million children are now insured nationally because of this provision, which already has been implemented.
“The bottom line is we need to get to a point where everyone can get the health care they need,” Praeger said. Not only is it a moral thing, she said, but costs will continue to escalate for those who pay for insurance if something isn’t done.
She said insurance companies estimate that 25 to 30 percent of the premiums they charge are to help cover uncompensated care.
Praeger, a Lawrence resident, gave an hourlong presentation about federal health reform Wednesday during a Lawrence Medical Managers meeting that was open to the public. About 50 people attended the program at Maceli’s in downtown Lawrence.
Praeger said it’s important for Americans to know the facts during this presidential election year because health reform is a hot-button issue.
She believes the Affordable Care Act is a work in progress but a good place to start in reforming the health care system. She said the Social Security system wasn’t popular when it was first introduced in 1935 but has been evolved over the years based on needs. She sees the same thing happening with the Affordable Care Act.
“If not this, then what?” she asked.
Kansas is among conservative states that are waiting to see if the Supreme Court overturns the law this summer or to see if the presidential election will make a difference. In the meantime, she said Kansas is falling behind and may lose decision-making control to the federal government.
For example, she said her department is currently researching what essential health benefits should be covered under insurance plans. The state needs to make a recommendation to the U.S. Department of Health and Human Services by the third quarter of this year, the deadline for HHS to certify them. Praeger said she will make a recommendation to Gov. Brownback and if he doesn’t move forward, then HHS will determine those essential health benefits.
The Affordable Care Act requires each state to establish by 2014 a health insurance exchange where individuals and businesses can purchase affordable health plans. She said the state likely will miss a January 2013 deadline for proving it has a plan in place for this, and therefore, HHS may end up facilitating the state’s exchange. She said the best-case scenario would be for the state and HHS to enter into a partnership.
Last year, she said, Kansas was chosen to be an early innovator for a state exchange and received $31.5 million in federal money, but Brownback sent it back.
“I just don’t see our Legislature giving us the authority to move forward, and we need that. We have to have a governance structure in place by January,” she said. “If we don’t, then HHS will take over. If we want to stay in control, we need to take action.”