Regardless of the Kansas residents' view toward the re-election of President Barack Obama, Kansas residents still face current and future changes imposed by the Affordable Care Act and will affect every single one of the state's residents.

A major point for Kansas is that of Kansas political representatives' actions (or failure to take action) regarding the 2014 implementation of insurance exchanges.

There will be formation of insurance exchanges by Jan. 1, 2014. These can be state exchanges or, in the absence of individual states electing to set up such, as Kansas has done, a federal insurance exchange. Kansas elected representatives chose to return the funds (or not accept) that the federal government offered to begin the process of setting up a state-sponsored insurance exchange in preparation for the pending implementation of Jan. 1, 2014, Affordable Care Act provisions. The position taken is the state would not set up an insurance exchange and, if the existing state insurance pool, which has oversight from the Department of Health isn't suitable, then residents could participate in or use the federal insurance exchange system.

There is one really big problem with this position. The Affordable Care Act language specifies clearly that only U.S. citizens who purchase their health insurance through a state-sponsored insurance exchange will qualify for any federal insurance costs subsidy that might exist. The Affordable Care Act further specifies people who engage in purchase of insurance through the federal insurance exchange will not be eligible for any reduced premium/subsidy or insurance costs offset support that will be available to those who qualify under guidelines and participate in insurance purchase through their state-sponsored insurance exchange.

The position the representatives of the state exposes Kansas residents to all the costs of the implementation and few if any of the benefits, in terms of truly "affordable care."

I see this as a lose-lose -- costs increase with no increased benefit to residents of the state possible. The misguided position of Kansas officials can only be remedied by quick action in notifying the U.S. Secretary of Health by Nov. 23 that Kansas will, in fact, engage in setting up an state-sponsored insurance exchange.

Rory J. Arnott, Lawrence (formerly of Grainfield and Zurich)