By John Hanna, Associated Press
TOPEKA (AP) — Kansas' insurance regulator is asking Gov. Sam Brownback to spell out the requirements for health coverage to be sold in a new online marketplace mandated by the federal health care overhaul, but Brownback still plans to make no decisions until after the presidential election.
Insurance Commissioner Sandy Praeger made her recommendations public Tuesday, a day after she sent the conservative Republican governor a letter containing her proposals for the "benchmark plan" that companies must offer to participate in the online marketplace. The federal health care law says such marketplaces, known as exchanges, will start operating in 2014.
Praeger's proposal calls for requiring companies to offer the same coverage Blue Cross Blue Shield of Kansas does in its comprehensive plan for small groups, along with additional coverage for children's eye and dental care. The commissioner noted in her letter that if Brownback does not set the state's requirements by the end of September, the U.S. Department of Health and Human Services could do it for the state.
Brownback has strongly criticized the federal health care law, enacted in 2010 and championed by President Barack Obama. Praeger, a moderate Republican, has praised the law as an important step toward providing universal access to health insurance, and she and Brownback disagree over how aggressive the state should be in setting up an exchange.
"My administration will not make any decisions regarding the implementation of Obamacare until after the November elections," Brownback said in a statement Tuesday, reiterating the stance he's long held.
States have until Nov. 16 to declare whether they still want to be partners in running an exchange or leave it entirely to the federal government. Kansas hasn't started to set one up because Brownback and Republicans who control the Legislature oppose the law. Brownback has argued that if Republican Mitt Romney defeats Obama, many requirements in the law are likely to be waived.
Praeger's proposal for the exchange's benchmark plan is designed to give consumers who use the online marketplace familiar coverage at competitive prices, said Linda Sheppard, the Insurance Department's project manager for the health overhaul.
"That does help the market stay stable," Sheppard said.
The federal government limited Kansas and other states to setting their benchmarks based upon 10 health plans already widely available to their consumers.
Blue Cross Blue Shield of Kansas provides coverage for about 900,000 Kansans, and Praeger is proposing that the exchange benchmark be tied to its most popular small group plan. At the end of March, more than 30,000 people were enrolled in it.
"Selecting this plan will allow for the most continuity in the marketplace as a large number of Kansans already have these benefits through their small business employer or as individuals," said company spokeswoman Mary Beth Chambers.
HHS has already said it would base its benchmark for Kansas on the same plan.
But the federal health care law requires that the benchmark include coverage for children's eye and dental care, and the biggest health plans in Kansas generally don't, except through supplemental policies. Praeger proposes that coverage for those plans mirror what's available through the state for children of working-class families that can't afford private insurance.
Sheppard said that if HHS sets the benchmark for Kansas, it could mandate different coverage for such services, as well as coverage for services such as speech and physical therapy.
"This is all kind of coming together in a really short time frame," she said. "The companies are obviously really anxious to get the benchmark set as early as possible."