Today the Kansas House of Representatives failed to pass House Concurrent Resolution 5032. This resolution would have amended the Kansas Constitution to provide Kansas protection from federal health care mandates. Specifically, the explanatory section of the bill states: “The purpose of this health care freedom amendment is to preserve constitutionally the right and freedom of Kansans to provide for their health care.”
The resolution failed to pass by a vote of 75 to 47. Two-thirds, or 84 votes, were required for passage of this constitutional amendment. This vote is part of the Kansas Economic Freedom Index.
A group of House members filed a protest, which is printed in the journal for the day. It’s a useful analysis of what the just-passed federal law will do for us, complete with references to the legislation:
MR. SPEAKER: Pursuant to Article 2, Section 10, of the constitution of the State of Kansas, we protest the non-adoption of HCR 5032.
The Federal Health Care legislation is a violation of the United States Constitution. The legislation is not within the powers granted to Congress through the Commerce Clause in Article I, Section 8. The legislation is unprecedented and unconstitutional because never before has Congress attempted to compel Americans to purchase any good or service simply as a requirement of lawful citizenship. Health Care has historically been a primarily a state responsibility.
Additionally, we protest the passing of Federal Health Care legislation, in part, for the following reasons:
The sections described below are taken from HR 3590 as agreed to by the United States Senate and from the reconciliation bill as displayed by the Rules Committee.
You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the ‘‘privilege.’’ (Section 1501)
You are young and healthy and want to pay for insurance that reflects that status? You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drinks a gallon of whiskey, eats chicken fat as often as possible and skydives. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).
You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).
Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).
You are an employer and you would like to offer coverage that doesn’t allow your employers’ children to stay on the policy until age 26? (Section 2714).
You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care. You’re a single guy without children? Your policy must cover pediatric services. You’re a woman who can’t have children? Your policy must cover maternity services. You’ve never had an ounce of alcohol or drugs? Your policy must cover substance abuse treatment. (Section 1302).
Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a ‘‘Bronze plan,’’ which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that will not be an option. (Section 1302 (d) (1) (A)).
You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? (Section 1302 (c) (2) (A).
If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? (Section 1513).
You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).
If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. (Section 3003 (I)).
If you are a physician and you want to own your own hospital, you must be an owner and have a ‘‘Medicare provider agreement’’ by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A)). If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a county where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed ‘‘unreasonable’’ by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003).
The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? (Section 9008 (b)).
The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, now how to better use that money, say for R&D? (Section 9009 (b)).
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? (Section 1405).
The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? (Section 9010 (b) (1) (A and B)).
You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. Do you think you know how to spend the money you earned better than the government? (Section 9015). That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? (Section 1402).
Instead, Kansas should support true Health Care reform that lowers cost, improves access and portability of health insurance. Shifting the high cost of health care today from an individual to the taxpayers is not the solution.
If the medical profession loses its humaneness and instead patients become lost in a sea of bureaucracy and quotas, patients will be hurt and numerous bright and talented people will shy away from becoming doctors. Instead, we must encourage competition. I believe almost all Kansans want the right to choose the health care plan, hospital, doctor, and prescription drug plan that is best for them
— BRENDA LANDWEHR, AARON JACK, ARLEN SIEGFREID, KEVIN YODER, MARC RHOADES, JOE SEIWERT. MARVIN KLEEB, PHIL HERMANSON, ELAINE BOWERS, JOE MCLELAND, DAN KERSCHEN, LANA GORDON, ANTHONY BROWN, MARIO GOICO, LEE TAFANELLI, PEGGY MAST, MITCH HOLMES, RAY MERRICK, WILLIE PRESCOTT, MIKE O’NEAL, CONNIE O’BRIEN, KASHA KELLEY, GENE SUELLENTROP, VIRGIL PECK, JR., DEENA HORST