Medicare Beneficiaries and States Rights Backers Differ on Role of Health Care Compact Legislation
Powerful forces hiding behind Super Pac money have made an attempt to change the delivery of Medicare using inter-state compact agreements to put all federal health care programs including Medicare under the control of state governments.
As more Medicare beneficiaries learn that nine states including Kansas have passed legislation to transfer control of Medicare to individual state legislatures, they want to know, who is behind this effort, what do compacts have to do with healthcare, and how would such a change affect their Medicare benefits.
Leo Linbeck III, a Houston billionaire and self-described “conservative communitarian”, believes, “states should be organized in a way to take health care away from a centralized federal government”.
Why? Linbeck wants to stop federal politicians, big corporations, lobbyists, and unions from cutting deals which he believes have created a system that is unsustainable.
Linbeck told writer, Stephanie Mencimer, of Mother Jones, during a 2011 interview “It would be up to the states whether to remain in Medicare or create their own version. States could use subsidies to have private insurance, Accountable Care Organizations or Single payer,” said Linbeck.
“To save Medicare, we need innovation that will come from the states acting as ‘laboratories of democracy’, as Justice Brandeis put it,”
While working as a fellow at the Texas Public Policy Foundation in Austin, Tx., Ted Cruz presented a report for the Center of Tenth Amendment Studies in December 2010, describing Obamacare as an “unconstitutional federal overreach and violation of the tenth amendment rights.”
Framers of the constitution added the tenth and final amendment to assure delegates of the limits of Federal powers. Cruz and co-author, Mario Loyola, director of the tenth amendment center, believe “interstate compacts” could be used to shield states from Obamacare.
The Constitution in Article I, section 10 allows states to form interstate compacts. Compacts date back to the colonial period and were designed to coordinate activities such as port-authority issues and reciprocal recognition of laws and licenses in member states.
Cruz and Loyola maintain an interstate compact could be formed to override the Affordable Care Act (Obamacare), with approval by Congress and without the need for the President’s signature.
But, Jeffrey Jackson constitutional law professor from Washburn University in Topeka told a Wichita Eagle newspaper reporter on August 3, 2014, “Compact supporters are overlooking the ‘Presentment Clause’ which states: ‘Every bill which shall have passed the House of Representatives and Senate shall, before it becomes a Law shall be presented to the President of the United States.’”
The Presentment Clause contained in Article 1, section 7 states, if the president approves the bill, he shall sign it. If not, he shall return it with his objections to both the House and Senate. It can only become law if approved by 2/3 vote of the House.
The Cruz-Loyola report stated, “Once Congress consents to an interstate compact, the compact carries the force of federal law, trumping all federal and state law.”
With backing from leaders of the Tea Party Patriots, Mark Meckler and Jenny Beth Martin, Cruz presented the idea at the 2010 American Legislative Exchange Council Conference (ALEC) .
By 2011, the ALEC-Health Care Compact model was supported by other activists including Eric O’Keefe, chairman and chief executive of the Sam Adams Alliance.
Both O’Keefe and Linbeck created the Health Care Compact Alliance Super Pac 501 (c) 4 and served as Chairman and Vice Chairman to generate more than $1 million dollars of seed money from undisclosed donors to bring the Health Care Compact idea to state legislatures throughout the country.
On November 30, 2011, the ALEC Health & Human Services Task Force approved the Health Care Compact legislation as a “model bill.”
The ALEC bill was introduced in the Kansas legislature during February 2012. The House brought it up for a vote and it passed 86-37, but later died in the senate.
The bill surfaced again in 2014, when Rep. Brett Hildabrand, and Sen. Mary Pilcher Cook, both from Shawnee, Ks. introduced House bill 2553 to join the Interstate Health Care Compact comprised of eight other states including: Utah, Texas, Oklahoma, Missouri, Indiana, Alabama, South Carolina and Georgia.
Under the compact, member states would have the authority to “suspend by legislation the operation of all federal laws, rules, regulations, and orders regarding health care,” including Medicare.
Pilcher-Cook said, “The health care programs would be less bureaucratic and more efficient if the state ran them.”
Rep. Jim Ward, a Democrat from Wichita did not agree. He proposed an amendment on March 21, 2014 to exclude Medicare from the Compact. Fifty seven (57) house members agreed with Ward and voted to remove Medicare from the bill. Sixty one (61) disagreed, and the Ward motion failed.
The Health Care Compact bill passed both the Kansas House and Senate and was signed into law by Governor Brownback on April 22, 2014.
Upon signing the bill, Governor Brownback wrote, “Similar to KanCare reforms to Medicaid, the Compact could play an important role in preserving and enhancing Medicare for Kansas seniors.”
Using Medicare to justify passage of the bill confused many because the Affordable Care Act enhanced Medicare benefits. As a result of this legislation, a statewide group has been formed to protect the future interests of Traditional Medicare beneficiaries.
The group, Kansans to Preserve the Federal Medicare Program believe the Health Care Compact is bad legislation for Kansans because guaranteed Federal Medicare benefits would be lost, severe revenue shortfall projections persist, and continued transfers from the highway fund to balance the state’s budget creates fears that funds designated for Medicare could be compromised if the Compact is approved by Congress.
The Health Care Compact arrangement between the nine states continues to face an uphill climb in Congress where the Lankford and Collins bills have died in House committees, and Kansas Secretary of State Kris Kohbach’s plea to 94 Republican members of Congress during July of 2015, urging “affirmation of a health care compact”, appears to have fallen on deaf ears.
