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Insurance Commissioner Praeger: Expand Medicaid and Oppose Privatizing Medicare through Health Care Compact Law

—by Larry Weigel—
October 16, 2014

Kansas Insurance Commissioner Sandy Praeger has been steadfast in protecting Kansas consumers and advocating policies that are in their best interests. From the time she was first elected as Insurance Commissioner in 2002, she set high standards of fairness, integrity and honesty in her relationships with insurance companies, consumers, lobbyists and members of the Kansas legislature.

"We treat everyone the same and try not to get caught up in the political jargon," said Praeger- as we chatted during September in her office located near the state capital in the former Topeka Women's Club building-now the permanent home of the Kansas Insurance department.

Sandy Praeger - photo credit: Larry Weigel

Retiring Republican Sandy Praeger, Kansas Insurance Commissioner is a strong advocate for Medicaid expansion

Praeger believes the elected position of an Insurance commissioner needs to be above politics and "run on issues you think are important." "I think it's easy enough to do without political mudslinging which is too prevalent today."

The mudslinging started for Praeger, a Republican- when she stood up to Republican Governor Sam Brownback and legislators within her own party in support of the Patient Protection & Affordable Care Act (ACA), and expansion of Medicaid, which they rejected.

Praeger said, "In the past, former Kansas insurance commissioners worked in a bipartisan way with both Democrats and Republicans in the legislature." But Praeger-who served three terms in the Kansas senate and one term in the House noted, "That has all changed now." "We have lost compromise in the political process when we saw what happened to Republicans who reached across the aisle to work with Democrats over school funding, and the extreme state income tax cuts proposed by Governor Brownback," Praeger said.

"In 2012 those Republicans were targeted in their primaries and were not reelected because they didn't toe the political party line."

Legislators who support repeal of Obamacare and want the insurance department to permit insurance companies to sell across state lines as an alternative to the ACA is also very troubling to Praeger.

"Someone who supports selling insurance across state lines just doesn't understand how health insurance is regulated," Praeger said.

She listed all the reasons why this is a bad idea, including; "The legislature decides which laws are in place, what mandates are required and a whole host of other regulations approved through legislative action that need to be enforced."

"To allow a company to get licensed in another state that has very weak consumer laws and then come into Kansas to sell insurance does not make sense,"

When asked what voters should look for in selecting their next Kansas Insurance Commissioner, she said, "I believe we need someone who doesn't listen to political rhetoric and is focused on just doing the right thing for the people of Kansas."

She listed the following issues as being the most important for Kansans.

Expansion of Medicaid was first. "Not expanding Medicaid for the state of Kansas is just foolish and makes absolutely no sense," she said with a look of passion and disappointment.

She cited the Urban Institute - Robert Wood Johnson Foundation data just released. "By not doing Medicaid expansion we, (Kansas) will forgo $5.6 billion in Federal dollars," Praeger said.

"The state price tag to expand Medicaid over the next ten years is $525 million. In my mind, that is penny wise and pound foolish."

Hospitals lose $2.6 billion," Praeger said . "Kansas would put up 10 percent of the cost but get 90 percent of Federal dollars coming to our state. And, those are our tax dollars going to the other states that approved the Medicaid expansion,"

"The only way you can justify not doing it is political, because there is no logic to it".

The Health Care Compact law passed by the Kansas legislature in April of 2014 was next.

Praeger said with conviction and assurance, "Anybody who supports the Health Care Compact does not understand the potential for damage to Medicare recipients in Kansas because what you are doing is bringing back all those dollars as a block grant which is different than an entitlement program the way it is now. People forget, Medicare is not a welfare program. It is part of the Social Security Act and a retirement benefit that we pay into."

Praeger explained, "If you have covered Medicare expenses they get paid. If you are part of a compact you have a certain amount of dollars and if expenses go higher than anticipated than you're going have to find other ways to balance those expenses."

"It means maybe balancing against the Medicaid program, public health services, federally qualified health centers or cutting services for Medicare recipients because you have agreed to the amount of Federal dollars available in 2010 which might already be way to low,-and- if it's too low, you are always catching up."

Praeger believes Democrat Dennis Anderson is the right fit and has the qualifications to succeed her over his GOP opponent Ken Selzer. Praeger endorsed Anderson publicly in September when she told the media, "I really want the department to be represented by an independent voice, someone who will listen to what Kansans want and not by a political ideology."

Kansas voters are best served if they base their voting decisions on the policies of each candidate. Below are the candidates' responses taken from previous statements made to the press on the issues outlined by Praeger.

Implementation of Affordable Care Act is important to Praeger.

Kansas Insurance Commissioner Democratic candidate Dennis Anderson

Kansas Insurance Commissioner Democratic candidate Dennis Anderson is a strong advocate for Medicaid expansion and a strong opponent of the efforts by Kansas Republicans (including his opponent) to withdraw from the Medicare health care program for seniors.

Anderson wants insurance coverage for all Kansans and will help them enroll on the Federal health exchange under provisions of the Affordable Care Act legislation (ACA).

Kansas Insurance Commissioner Republican candidate Ken Seltzer

Kansas Insurance Commissioner Republican candidate Ken Seltzer is a proponent of removing Kansas from the federal Medicare program for senior healthcare and a strong opponent of Medicaid expansion. He believes that Kansas Republicans can make better decisions about how to allocate health care to Kansans, including Kansas' seniors, than the federal government.

Selzer wants to repeal the ACA and believes his job doesn't involve helping consumers find insurance plans on the federal exchanges.

Here are the candidate comments on The Medicaid Expansion issue.

Selzer opposes Medicaid expansion. Anderson favors Medicaid expansion to help those Kansans with limited income get health coverage.

Comments from the candidates on The Health Care Compact issue!

Selzer wants to remove Kansas from the Federal health care program including Medicare, and join the other eight states in the compact.

Anderson opposes the Health Care Compact and does not want the Kansas legislature to take over the management of Medicare where Medicare beneficiaries would be at risk losing their current guaranteed benefits as Prager noted.

Sandy Praeger, a true public servant

The Medicare topic led to a discussion about Praeger's eventual retirement from public service. "In a few months, I'll be ready for Medicare," she said. Praeger leaves office in January of 2015 when the newly elected Commissioner takes over the reins.

Praeger has had a long distinguished career in serving others. She was mayor of Lawrence, Ks, a member of the Lawrence city commission and a member of the Kansas legislature, before seeking the Insurance Commissioner's position.

During her twelve years as Commissioner (2003-2014), she was elected by her peers as President of the National Association of Insurance Commissioners (NAIC), and received the American Medical Associations most distinguished award twice for her significant contributions to public health.

She lives in Lawrence with her husband Dr. Mark Praeger. They have two married children and three grandchildren.

After reviewing her exceptional accomplishments and witnessing her charm, poise, intellect and political savvy, I believe she will be remembered as the Insurance Commissioner "who did the right thing for the people of Kansas."

—Larry Weigel
The Medicare Coach