FRANKFORT —
The fight over health care reform isn’t just in Washington or at the November polls. It burst into view Tuesday in Frankfort as well.
Gov. Steve Beshear issued an executive order establishing the Kentucky Health Benefit Exchange, a component of the Affordable Care Act (ACA) which is designed to help lower-income and uninsured people find health insurance.
But, almost immediately, a legislative panel turned thumbs down on a $300,000 lease the administration sought for office space for 210 employees who will man the health exchange. The Capitol Projects and Bond Oversight Committee voted along mostly partisan lines not to approve the lease. The secretary of finance, Lori Flanery, can override the committee and approve the lease.
Voting no were Republicans Sen. Tom Buford, Sen. Jared Carpenter, Rep. Steve Rudy and Independent Sen. Bob Leeper, who usually votes with Republicans. Committee Chairman Rep. Jim Glenn, D-Owensboro, Rep. Jim Wayne, D-Louisville, and Sen. Julian Carroll, D-Franklin, voted to authorize the lease.
But leading the charge during the questioning was Senate President David Williams, R-Burkesville, who isn’t a voting member of the committee. He asked Carrie Banahan, executive director of the Office of Health Policy in the Cabinet for Health and Family Services, how the office will be funded and what its budget will be.
Deputy Budget Director John Hicks ended up answering the first question: with a $66 million federal grant for the first two years, echoing a statement Beshear released with the executive order.
“The development and operation of the Kentucky Exchange will be funded entirely with federal dollars until Jan. 1, 2015, after which the Exchange will be wholly funded with revenues it generates,” Beshear said in the statement.
As for the budget, Banahan said, “You know, we are in the process of building that budget as we speak.” She gave the same answer each time Williams rephrased the question.
The health care reform law mandated each state establish exchanges to match consumers with insurers and direct those facing difficulty in paying for health insurance to federal subsidies or enrolling those whose income is 133 percent of the federal poverty guideline in Medicaid. The exchange must be operational by Jan. 1, 2014 according to the law.
The ACA — derisively called “Obamacare” by its critics — is opposed by Republicans who have promised to seek its repeal and is an issue in the presidential race between President Barack Obama and his presumptive Republican opponent Mitt Romney.
The law authorizes the federal government to set up and operate exchanges in states which don’t do it themselves. Several Republican governors have said they will delay establishing the exchanges until after the November elections after which they hope a new Republican president and congress will repeal the law.
In Kentucky, Williams and House Minority Leader Jeff Hoover, R-Jamestown, have urged Beshear to delay implementation of the health exchange and the proposed expansion of Medicaid for those otherwise unable to pay for health care. Both say the costs of the Medicaid expansion could be enormous — although the federal government will pay 100 percent of the costs the first three years and 90 percent thereafter.
Wayne and Carroll, however, said the law has passed, been upheld by the Supreme Court and it is Kentucky’s responsibility to move forward under its provisions. Besides, said Wayne, the current system is unworkable.
“The present system is unsustainable,” he said in making the motion to approve the lease. “It’s going to bankrupt this country.”
Williams also objected to the timing of the order and the appearance of administration officials before the committee. He said the order was issued 10 minutes after the committee began its meeting and Beshear hadn’t bothered to brief legislative leaders or committee members before asking them to approve the lease.
He said Beshear should have briefed lawmakers on “one of the biggest public policy changes in the history of the commonwealth.”
The executive order also establishes an Exchange Advisory Board. Its 11 members are to have experience in such things as health benefits, health insurance, health administration or policy. Beshear will appoint the chairman and said he hopes to announce membership in August.
RONNIE ELLIS writes for CNHI News Service and is based in Frankfort. Reach him at rellis@cnhi.com. Follow CNHI News Service stories on Twitter at www.twitter.com/cnhifrankfort.
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