Health Care Law: Lieutenant Governors Advised To Focus On Quality Of Care

WASHINGTON -- The nation's lieutenant governors were advised to focus on the quality of health care delivery, along with potential insurance challenges as the Affordable Care Act heads for the Supreme Court next week.

During a panel discussion at the National Lieutenant Governors Association meeting, the lieutenant governor of Kansas and the state's former governor told the state second-in-commands to focus on the delivery of care, the future of long-term care, and the costs of health care, regardless how the Supreme Court rules on President Barack Obama's signature domestic policy. Part of the discussion focused on how to gauge the delivery of health care at the state level.

"Let's focus on outcomes and what are real results. I want to look at the whole person," Kansas Lt. Gov. Jeff Colyer (R) told his colleagues. "We want to have a stable safety net."

Colyer, a plastic surgeon, tried to stress his own medical career as part of the discussion, which included his work on rewriting Medicaid policy in Kansas. He said his plan seeks to reduce costs for state government, while focusing on women and children, the disabled and the aging.

Jean Sullivan, director of the Center for Health Law and Economics at the University of Massachusetts, told lieutenant governors that if the Supreme Court strikes down the health care law, the first burden will be on state insurance departments. She said this will include grappling with issues of insurance for those with pre-existing conditions and life-long health care issues.

If the Supreme Court upholds the Affordable Care Act, Sullivan said, states will have to rapidly plan health care exchanges. Many states have stopped planning for the exchanges, which are to be operational in 2014, pending the outcome of the case. If a state fails to implement an exchange, the federal government will operate the exchange for that state. The irony in this is that many states delaying work on exchanges are those with leaders who would prefer keeping the federal government out of state business, Sullivan said.

Sullivan also said states have to plan for parts of the law that shift more Medicaid costs to states, which take effect in 2017.

"States need to think ahead for what their revenue plans are," Sullivan said.

Former Kansas Gov. Mark Parkinson (D), the president of the American Health Care Association, advised the lieutenant governors to focus on long-term care issues. He said the focus should be on end-of-life issues, along with the quality of long-term care. He stressed that long-term care continues to consume a large amount of health care spending.

Colyer, who stressed the importance of health care on state economies, said that any decisions need to be made carefully to avoid a negative economic impact. He also stressed a conservative line to his colleagues.

"The other big issue that the Supreme Court is considering is how worse can the federal government be," Colyer said. "Where is the partnership here?"