Sen. Mary Ware says lawmakers are giving Kansas Farm Bureau a blank check by allowing the organization to offer an unregulated, cheap alternative to health insurance.
Ware, a Democrat from Wichita, railed against the uncertainty surrounding the authorization of Farm Bureau's plans, which will undercut other insurance providers by ruling out coverage for pre-existing conditions.
Farm Bureau hasn't drafted coverage terms for Kansas yet, but the organization won't have to cover serious ailments and could raise premiums without fear of oversight from the insurance commissioner because the product won't be classified as insurance.
"This bill," Ware said, "would allow one company to cherry-pick and only cover the healthiest Kansans, thereby further destabilizing our insurance industry by leaving the real insurance companies with a sicker pool, creating a very uneven playing field. We all desperately want better, more affordable health care for Kansans, but this most definitely is not the way to do it."
Republican-led majorities ensured passage in both chambers this week, sending a deal to the governor that bundles the Farm Bureau plan with insurance-related bills. The Senate passed the legislation 28-12 on Thursday, and the House passed it 84-39 on Friday.
Supporters lament the failings of the Affordable Care Act to tamp down rising costs of health insurance premiums that small business owners, farmers and the self-employed can't afford.
They also point to the sterling reputation of the Kansas Farm Bureau as a membership-driven, 100-year-old organization with a presence throughout the state.
"I know them personally," said Rep. Jene Vickrey, R-Louisburg. "They will hire agents that are dependable, trustworthy. They will develop a plan that is reliable, that is explained well."
Rep. Ron Hineman, R-Dighton, said residents in his large, rural district of western Kansas are priced out of the health insurance market by skyrocketing premiums.
Aspiring entrepreneurs, Hineman said, are forced to abandon dreams of running a small business. The Farm Bureau plan would give them an option, he said.
“We’re stifling that dream by not having options for those people," Hineman said. "Is this option perfect? No, it isn’t, but neither is any other option available to those people, and they are clamoring for some sort of solution."
Democrats say uninsured Kansans would be better served by Medicaid expansion, which would provide coverage to 130,000 low-income adults and their children. The Farm Bureau says it expects 42,000 Kansans will sign up for its plans.
Those plans will be tailored to each individual. In Tennessee and Iowa, the Farm Bureau screens applicants for STDs, diabetes, high blood pressure, joint pain, diseases and disorders, and medications. Prescription drug costs are capped at $7,500 per person.
In addition to excluding coverage for pre-existing conditions, there are no guarantees that plans will offer coverage for things like mammograms, prostate exams, mental health or arthritis. More serious health problems, such as heart attacks, cancer and lung disease, may not be covered or could trigger a sudden spike in monthly premiums.
“It is a black box," said Rep. Elizabeth Bishop, D-Wichita. "We don’t truly know what’s in it. I know we’ve been told what will happen, what will be covered and so forth. But we haven’t seen anything, and this is a plan that will have none of the usual guardrails around it.”
Bishop said the plan exempts one company from the federal and state requirements that others who offer health insurance must follow. She said the situation would be comparable to telling Kroger that it didn't have to collect sales tax like all the other grocers.
The other grocers would object, Bishop said, just as insurance companies object to giving Farm Bureau special treatment.
Rep. Stephanie Clayton, D-Overland Park, said lawmakers should consider whether the Farm Bureau plans might be anti-family.
Women who sign up for Farm Bureau coverage are blocked from receiving maternity care for nine months because pregnancy is considered a pre-existing condition.
“It stands to reason many families are created when two people love each other very much and decide to reproduce," Clayton said. "And as such, this is a healthy, normal process.”
Under the legislation, Farm Bureau will have to make an annual financial report to the insurance commissioner, which could offer some insight into the way plans are implemented in Kansas. Vickrey said the plans will be tailored to the needs of Farm Bureau members in this state and won't necessarily mirror the ones provided in Tennessee or Iowa.
“The big issue for them is affordability," Vickrey said. "It’s not all these other issues that have been discussed."
Sen. Richard Hilderbrand, R-Baxter Springs, said Farm Bureau is taking a risk. The insurance giant offers other types of coverage, Hilderbrand said, and will lose membership if people aren't satisfied with how the organization handles the health plans.
Members can look at the plans and ask if they meet their medical needs, Hilderbrand said.
"They can then decide: I'm going to pay for this plan, I'm not going to pay for this plan," Hilderbrand said. "It's their free will. If it's not a good plan, people aren't going to buy it."