The growing ideological rift in the Kansas Republican Party has engulfed the implementation of the federal health care reform law, leaving the future of the state's role in Obama's health care reform program hanging in the balance.
Conservative Republicans in the Kansas House of Representatives are leading an effort to defund the state's share of the implementation of a health care exchange, saying that the state should not be taking any action to implement the law until after the U.S. Supreme Court rules on the case later this year. The move -- which the state's moderate Republican insurance commissioner is objecting to -- is being done in accordance with a resolution adopted by the Kansas Republican Party last year.
"It is the GOP's intent to say 'no more,'" said state Rep. Pete DeGraaf (R-Mulvane). "Until [health care] gets decided, the Republicans in Kansas have strongly spoken."
DeGraaf said he and other House Republicans want Insurance Commissioner Sandy Praeger to stop implementing the health care exchange, a component of the health law that requires states to create programs and websites to allow for consumers to compare and contrast health insurance plans. Praeger has sought to create the program, saying that the law's passage by Congress and President Obama binds her to start working on the state exchange until the court makes a ruling. A Supreme Court ruling is not expected until late June.
"We are telling her to cease and desist," DeGraaf said.
Praeger told HuffPost that she is going to continue the fight to keep the funds available to implement the exchange, noting that this will allow Kansas to control the state's version of the program rather than pass control over to the U.S. Department of Health and Human Services. She said a state controlled exchange -- or a hybrid of federal and state control -- would allow the state to help determine which plans to offer and decide the role the state's insurance community will play. Praeger also expressed concern that federal control of a group of state exchanges could impact the state's control over Medicaid services.
States have until early 2013 to implement the exchange system or HHS will take control. Praeger said that, according to her research, waiting to implement an exchange until after the Supreme Court ruling would make it impossible for Kansas to meet the deadline. She also noted that the court may only deal with the individual mandate portion of the law, which would leave the exchange part untouched.
While the state House Appropriations Committee has passed the defunding measure and full House passage is expected, it is possible the state Senate could block the proposal. While conservative Republicans control the Kansas House, moderate Republicans control the Senate and have teamed with Democratic lawmakers in the past to block conservative measures backed by the House and Gov. Sam Brownback (R). Brownback has indicated that he would sign any measure opposing the federal health care law and has returned federal implementation funds.
Praeger and Democrats expect the moderate GOP senators to block the measure, but DeGraaf said he is undeterred by the potential of a Senate defeat.
"Who knows what the Senate will do," he said. "This is the position of the House and the [state] GOP."
Kansas Democrats are not surprised by the move, and some suggested that the conservative leaning American Legislative Exchange Council is behind it.
"We have our conservatives on steroids," said state Rep. Jim Ward (D-Wichita). "They are taking this ALEC line of not agreeing to anything."