- Associated Press - Friday, April 4, 2014

TOPEKA, Kan. (AP) - A bill that would bring Kansas into a compact with other states hoping to become exempt from the federal health care overhaul won final legislative approval Friday night.

The state Senate approved the measure, 29-11. Because the House passed the bill last month, final Senate approval sends the measure to Gov. Sam Brownback.

Eight other states, including Missouri and Texas, have enacted similar legislation, according to Competitive Governance Action, the Houston group pushing the idea. The group describes itself on its website as a nonprofit that advocates state control over health care and having problems solved “by the smallest, least centralized, most local authority.”

The compact would not take effect unless Congress also agreed to it, and critics of the Kansas bill have questioned whether that would happen, particularly with President Barack Obama’s fellow Democrats controlling the U.S. Senate.

The governor wouldn’t say Friday whether he’ll sign the measure. He said he’s familiar with the compact concept in general, but as for the bill, he said, “I haven’t been through it enough to know.”

Brownback and most other Republican officials in Kansas are strong critics of the 2010 federal health care overhaul championed by Obama. The GOP-controlled Legislature blocked Kansas from setting up an online health insurance marketplace or expanding its Medicaid program for the needy and disabled as encouraged by the federal law.

In fact, the House approved a bill Friday to indefinitely extend a ban on expanding Medicaid that is due to expire in July 2015. The 68-54 vote sends the measure to Brownback, because the Senate approved it last month.

Most Republicans view the federal health care law as intrusive, burdensome and likely to harm the economy. They have said repeatedly that the rocky rollout of the federal online marketplace’s website confirmed their fears.

The proposal for a compact of states seeking to avoid the federal health care law relies on an obscure provision in the U.S. Constitution that requires congressional approval for such multistate agreements. The provision doesn’t give the president a role, making the idea attractive for some critics of the health care overhaul.

The compact also would allow the member states to seek an exemption from other health care regulations. They include regulations for Medicaid, which is funded jointly by the states and federal government, and even Medicare, which provides health coverage for seniors and is fully financed by the federal government.

“It would allow the state of Kansas to once again be back in control,” said Sen. Mary Pilcher-Cook, a conservative Republican.

Even some supporters don’t see Congress approving a compact unless Republicans capture control of the U.S. Senate in this year’s elections. Many critics see the proposal only as political symbolism.

Obama and other supporters of the health care law argue that it’s bringing health coverage to millions of Americans who have been uninsured. They’ve also argued that some provisions, such as barring insurers from denying coverage over pre-existing medical conditions, embody popular ideas.

Sen. Tom Holland, a Baldwin City Democrat, suggested the bill would allow member states to set up a bureaucracy to oversee health care programs, work in concert with large corporations and shield decision-making from public scrutiny. He predicted that a compact would turn health care over to a small “cabal.”

“This is a real song and dance being sold to you,” Holland said.

AARP has lobbied against the bill because the compact would allow participating states to exempt themselves from regulations for Medicare, which covers 450,000 Kansas seniors. AARP sees the potential for cuts in benefits, though supporters of the bill described the group’s arguments as scare tactics.

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Information about the compact bill: https://bit.ly/N6BWsQ

Kansas Legislature: https://www.kslegislature.org

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Follow John Hanna on Twitter at https://twitter.com/apjdhanna .

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