Proponents of the multistate health care compact have touted how “it would allow the state of Kansas to once again be back in control,” as Sen. Mary Pilcher-Cook, R-Shawnee, put it. “This is a states’ rights issue of returning health care back to the states,” said Rep. Brett Hildabrand, R-Shawnee, as Gov. Sam Brownback signed the bill last week. That “back-in-control” talk is misleading at best. States have never had a role in providing services and benefits via Medicare, which is the federal health insurance program covering people 65 and older and certain people with disabilities and permanent kidney failure. The Kansas Insurance Commissioner’s Office has a regulatory role relating to Medicare supplemental plans and private companies that have contracted with the federal government to provide Medicare. But the control and authority rest with the federal government. So if the health care compact wins congressional approval, Kansas will be assuming responsibility for Kansans’ Medicare not “again” but for the first time.
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