By Bryan Lowry

Tribune News Service

WICHITA -- When conservative lawmakers passed a bill committing the state to a health-care compact that would be independent of federal regulations, some called it a "postcard vote" that could be used against moderates and Democrats.

However, the policy has become a liability for Gov. Sam Brownback and some of the Republican lawmakers who supported its passage as seniors worry about its potential effect on Medicare.

"All elections are important, but this one is especially so for all senior citizens covered by Medicare," wrote Duane West, the 82-year-old former mayor of Garden City in an email urging support for Democrat Paul Davis in the governor's race.

It's also become an issue in the tight race for U.S. Senate. Congress would have to approve the compact before it could go into effect.

"It just terrifies me. My philosophy is if it's not broke, don't fix it," said Sandy Love, a retired postal worker who lives in Maize. "If they do that I'm sure we're going to lose some of our Medicare benefits, so it's just real scary to me. And I would think all seniors would really be concerned about that."

Love, 68, is a registered Republican, but she said she will not vote for any candidates who support the compact.

The legislation, which was developed by the Texas-based Competitive Governance Action, would give member states "the authority to suspend by legislation the operation of all federal laws, rules, regulations and orders regarding health care." They can do so under the Constitution's compact clause, which allows states to make agreements on commerce if they are approved by Congress.

Kansas is one of nine states to pass the measure along with neighbors Oklahoma and Missouri. States would receive federal health care dollars as a block grant and be able to set their own regulations under the proposal. That would include making changes to Medicare.

"I think a lot of seniors would leave the state if this became a reality," Love said.

Brownback said he would oppose any changes to Medicare when he signed the bill earlier this year over opposition from the AARP and Insurance Commissioner Sandy Praeger. Democrats said the bill would enable Brownback to privatize Medicare similar to how the state privatized Medicaid.

Conservatives have dismissed these claims as political spin.

"I think liberals are trying to create scare tactics with senior citizens with what it's going to do to Medicare, where again I think this solidifies Medicare and strengthens that source of revenue," said Rep. Brett Hildabrand, R-Shawnee, who sponsored the legislation. He said the Affordable Care Act posed a greater threat to Medicare in the long term.

He also said that some of his fellow conservatives have exaggerated the short-term impact of passing the bill. The policy is a long way away from becoming reality at this point.

U.S. Rep. James Lankford, R-Okla., introduced a bill to approve the compact in the U.S. House, but it has failed to gain traction. It would also be unlikely to pass in the Democratic-controlled Senate.

However, Lankford is running for the Senate and holds a 33-point advantage over the Democrat in the race, according to RealClearPolitics, a site that aggregates data from competing polls. And if Republicans take control of the Senate, compact supporters believe it may be able to pass.

Even then Washburn Law professor Jeffrey Jackson says the compacts require presidential approval and it's unlikely that President Barack Obama would sign a policy meant to dismantle the Affordable Care Act, also known as Obamacare.

The Eagle has received multiple inquiries from readers who want to know where U.S. Sen. Pat Roberts and his independent challenger Greg Orman stand on the issue.

Orman took a hard stance against the proposal.

"I think taking our health care dollars for seniors and putting them in the hands of a governor who raided our transportation trust fund providing tax cuts for the wealthiest Kansans is the height of irresponsibility," Orman said in a statement. "I would absolutely vote against that measure and ultimately if the President vetoed it I would vote to sustain the veto."

The Roberts campaign did not answer the question directly and instead reasserted the senator's opposition to the Affordable Care Act.

"Senator Roberts' first priority when it comes to healthcare is to repeal and replace Obamacare .... Once Obamacare is repealed, we can replace it with conservative reforms that lower costs, restore the doctor and patient relationship and protect our seniors," said Roberts' campaign manager Corry Bliss in an e-mailed statement.

When pressed for clarification, Bliss said in a phone call that Roberts "supports nothing until Obamacare's repealed and replaced."

However, the group Tea Party Express, which endorsed Roberts last week, specifically lists the compact as a reason to vote for Roberts.

"We need Senator Roberts to stay in the Senate and on the Health Committee to help us pass the Health Care Compact to bypass Obamacare in Kansas," says Morgan Sharp, a Kansas Tea party activist, on the group's endorsement page.

Obamacare is the most important issue for 26 percent of voters, according to a KSN and SurveyUSA poll released earlier this month, and among those voters Roberts, who supports repeal, has a 2-to-1 advantage.

However, that doesn't mean that voters will gravitate toward the compact plan if it could allow changes to Medicare.

"There's almost no support for changing Social Security or Medicare, so it stands to reason then that if you're talking about a state challenge to this federal guarantee that would be something that would make people nervous from the very beginning," said Chapman Rackaway, a professor of political science at Fort Hays State University.

Campaigning on the vote

Last month The Best Times, a community magazine for Johnson County seniors, published an article "Kansas on the road to eliminating Medicare?" written by the Johnson County Area Agency on Aging.

The article was published alongside a retort "Kansas Legislature saves Medicare with innovative Obamacare fix" undersigned by 23 Republican lawmakers. This was a compromise struck by the county after GOP lawmakers demanded in a September meeting that the agency pull its article.

"To come out and scare people on purpose is dishonest and reckless," said Rep. Charles Macheers, R-Shawnee, in audio that was posted by the Kansas Health Institute.

Sen. Jeff Melcher, R-Leawood, accused the agency of dropping "an October surprise" in a partisan move meant to hurt Brownback and other Republicans.

But moderates saw the bill as a political attack against them.

"I think it was initially just run as a postcard vote to hurt and frighten moderates. It was run to control the caucus," said Rep. Stephanie Clayton, R-Overland Park, who opposed the bill and face a flood of mailers on the issue before the August primary.

Moderates who voted against the bill were attacked with mailers from Americans For Prosperity and the Kansas Chamber of Commerce accusing them of supporting the Affordable Care Act.

"Every mailer in my primary had a photoshopped picture of me with Obama or Obama and Sebelius or some depiction of the president, myself and suggesting I was sympathetic to Obamacare," Rep. Russ Jennings, R-Lakin, a moderate who staved off a primary challenge.

Jennings said he opposed the bill primarily "because of the potential negative impact this could have on Medicare. And Medicare, at least in my view, is probably one of a small number of federal programs that seems to work well. That was my big hangup."

The House Speaker's office denied that the bill was pushed forward as a postcard vote and said that it made it through the normal legislative process.

"The Health Care Compact passed because our legislators hear frequently from constituents about the damage Obamacare is doing to their finances, and how healthcare insurance premiums are doubling and tripling. So the opportunity to join eight other states in creating a compact that would give Kansas control over health care dollars was popular," Speaker Ray Merrick said in a statement. "Now the bill is being used to incite fear where none is warranted. Republicans in state government have no intention or desire to take over Medicare."

Hildabrand said there could have been some lawmakers who intended the bill as a postcard vote. But he said that as the lead legislator on the bill, "my intent from the very beginning is to hope Congress would actually act on it. And I still hope if Republicans retake the Senate in November that we will see action on it."