Published July 29th, 2014 at 4:11 PM
No fewer than five candidates are seeking the Republican nomination for Kansas insurance commissioner, an office that has been dominated by Republicans since its creation in 1871. In the 20th century, only one Democrat has held the office, Kathleen Sebelius, who used it as a springboard to become Kansas governor in 2003 and, in 2009, Secretary of Health & Human Services in the Obama administration. It was Sebelius who oversaw the rollout of the signature legislative achievement of the administration’s first term, the Affordable Care Act, or, as it has become known, Obamacare. Not surprisingly in one of the reddest of red states, all five Republicans oppose the health reform law, although only one, Ken Selzer, explicitly favors its repeal.
The primary winner on Aug. 5 will face off in the fall against the lone Democrat in the race, Dennis Anderson. The winner in November will succeed Sandy Praeger, who was elected in 2003 and is stepping down. Praeger, a moderate Republican, supports Obamacare, which has put her at odds with the state’s conservative governor, Sam Brownback. While it may appear surprising that so many people are seeking the office, the insurance commissioner wields considerable power. The office regulates insurance companies, examines them for financial solvency, ensures compliance with insurance regulations, licenses insurance agents, and educates and assists consumers. Since the passage of Obamacare, it has assumed even greater importance as the state agency responsible for overseeing the law’s implementation in Kansas.
Today we profile four of the candidates seeking the Republican nomination. The fifth, John Toplikar, a former Kansas House member who now serves as county commissioner for Johnson County’s 6th District, did not respond to numerous requests for an interview.
Occupation: Insurance agent
Family: Married, four children
Affordable Care Act: Opposes the health reform law, saying it has led to less competition and higher prices
Medicaid expansion: Opposes expansion, saying Medicaid beneficiaries are the “biggest abusers” of emergency-room care
Insurance navigators: Calls them a “terrible idea,” saying independent insurance agents can help find consumers suitable coverage
Occupation: Life insurance agent
Family: Married, three children
Affordable Care Act: Calls it an example of “overreach by federal government”
Kansas insurance market: Wants to attract new companies to compete for consumers’ business
Insurance navigators: Says he wouldn’t involve them in “any way, shape or form” in educating consumers
Family: Married, two children
Affordable Care Act: Opposes it as intrusive and unworkable federal mandate
Medicaid Expansion: Opposes expansion, favors increased coverage through employee-based policies
Kansas health insurance market: Says there is not enough competition and would work to draw more companies into the state
Occupation: Title insurance agent
Family: Married, six children
Affordable Care Act: Says he’s committed to educating consumers and helping them navigate their choices
Medicaid expansion: Opposes it but is open to private-sector approach to expansion
Kansas heath insurance market: Favors multistate approach to asserting control over federal health dollars
Beverly Gossage stands out as the only woman among the five Republican candidates for Kansas insurance commissioner.
But she’s in lockstep with her male counterparts when it comes to the highest-profile issue in the race: the Affordable Care Act, or Obamacare — the health reform measure that was the signature accomplishment of the Obama administration’s first term — and how she sees it affe
“People have fewer policies to choose from; people are losing their policies,” Gossage says. “There’s less competition. Premiums are increasing. I see this every day with my clients.”
If she’s elected insurance commissioner, Gossage, who lives in rural Johnson County, says she will encourage insured and uninsured Kansans to meet with an independent agent before they explore their options in the federal government’s online health insurance marketplace, also known as the health insurance exchange.
“Everything that’s available on the exchange is available in the private sector, and the private sector has more options,” she says. “We have 20,000 independent insurance agents in the state of Kansas who can help people find the policy that’s best for them.”
Gossage, who has been a licensed insurance agent since 2002, calls the current practice of using trained volunteer “navigators” to help people determine which marketplace plan might best meet their needs “a terrible idea” that’s not worth continuing.
“I would not promote navigators, and I would not be a party to Kansas’ bringing down $900,000 in federal dollars for navigators,” she says, referring to federal navigator grants awarded to three Kansas organizations last year.
“We have 20,000 licensed insurance agents who are ready and willing to do this work without costing taxpayers a dime,” Gossage says. “They know these policies inside and out; they know all the options.”
Sheldon Weisgrau, director of the Health Reform Resource Project in Kansas, disputes Gossage’s description of the navigators.
“The truth is that not very many navigators are paid, they’re mostly volunteers,” he says. “There are a few at some of the FQHCs (Federally Qualified Health Centers, also known as safety-net clinics for the uninsured) who are paid through a federal funding stream that is available, but these folks were some of our busiest navigators. I find it hard to believe that many of them were sitting around with nothing to do.”
Health care advocates, Weisgrau says, do not object to insurance agents helping people find health insurance through the federal marketplace.
“We think there are enough people to go around; there are roles for both agents and navigators,” he says. “To say one is better than the other is a bit of a ‘straw man’ argument and is irrelevant.”
If elected, Gossage says she would limit the insurance department’s involvement with the Affordable Care Act to one thing: posting a link to the www.healthcare.gov marketplace on the department’s website.
In her work as an insurance agent, Gossage, 64, specializes in helping individuals, families and businesses set up health savings accounts.
She and her husband, Robert, live in the country between Eudora and De Soto and have four grown children. “He is my childhood sweetheart,” Gossage says. “We’ve known each other since sixth grade.”
Gossage has a bachelor’s degree in education from Central Missouri State University. She taught elementary school for eight years before becoming a regional administrator for Sylvan Learning, a national company that tutors students outside regular classroom settings.
Gossage described herself as a free-market conservative.
“I like for there to be a lot of competition and for there to be a lot of products to choose from,” she says. “And I’m opposed to mandates. If a husband and wife can’t have children and don’t need or want maternity coverage, I don’t think they should have to have it. But with Obamacare, they have to have it. All I can do is say, ‘I’m sorry you have to have it, you have to pay for it.’”
Her opposition to government mandates, she says, extends to a law passed earlier this year that requires individual health insurance policies sold in Kansas to begin covering autism treatments for children. Many Republicans supported the measure.
“That’s a mandate,” Gossage says. “I’d like for the carrier to decide what they’re going to cover.”
Gossage, who home-schooled her dyslexic son, says she sympathized with the families of autistic children. But she says mandates force insurers to raise premiums.
On other topics, Gossage says:
She “doesn’t have a problem with” insurance plans covering birth control, but she’s strongly opposed to employers being required to cover drugs that terminate pregnancies after conception.
She favors Kansas joining a multistate compact designed to break member states’ ties with Obamacare while letting them take over the Medicare and Medicaid programs within their borders. “I like the idea of block-granting the (federal) funds and not having the federal government telling us in Kansas how we need to do things better when we know how to take care of Kansans.”
She supports Gov. Sam Brownback’s resistance to expanding the state’s Medicaid program, noting that Medicaid beneficiaries are the “biggest abusers” of emergency-room care.
Gossage says that if she’s elected, she would begin the process of spurring a much-needed public discussion on the merits of workers depending on employers for their families’ health insurance.
A better approach, she says, would be to have businesses give their employers stipends that they could use to buy the coverage that best meets their needs and would be portable, from job to job.
The current employer-based system, Gossage says, wreaks havoc when companies go out of business or lay off workers, especially those who have developed chronic conditions that make finding replacement coverage difficult.
David Powell didn’t choose insurance sales as his original career path. He was a mathematics teacher and coach in El Dorado when the Texas-based American Amicable Life Insurance Company contacted him in 1977.
The company had a recruiting program aimed at coaches. Powell says it was based on the notion that the preparation and planning required for coaching would be useful skills for selling life insurance.
“Your success, of course, depends on your ability to prepare for the next interview in this case, and that’s what I did. I was very successful,” says Powell. “When I found that I made more money that summer part-time than I made as a teacher coaching five sports, I decided the following year that I would go full-time.”
That was 37 years ago, and Powell, who still lives in El Dorado, has been selling insurance ever since. He says he’s the only Republican candidate for Kansas insurance commissioner who has experience in all of the major lines of insurance.
Powell, 68, says he decided to run for office after someone suggested it would be a way for him to help the entire state.
“I have no ambition for higher or other office,” says Powell. “This is something that I want to do. I believe that I can improve insurance for everybody … individuals, families and businesses in our state.”
Powell sees a competitive insurance market as part of what he calls a “three-legged stool,” along with Gov. Sam Brownback’s income tax cuts and a renewed emphasis on vocational education, to help Kansas attract new businesses.
“We want to bring more companies to compete for the consumers’ business, and when that happens — the free market happens — we see rates improve. We see new products being developed, because that’s one thing that will attract a new buyer,” Powell says.
“I’ve worked with companies that have tried to bring new products to Kansas, and have either given up or a couple of years down the road they’re still trying to get it into our state. But Missouri has it, Oklahoma has it, Nebraska has it and Colorado has it. Why don’t we?”
If elected, Powell’s approach to the Affordable Care Act would be different from that of the current commissioner, Sandy Praeger, a moderate Republican who has tried to work cooperatively with the federal government to implement the health reform law.
He sees the ACA as an example of what he calls “overreach by the federal government.”
“I do not like the ACA designation,” Powell says. “I think that’s a media way of trying to lull you to sleep, because there’s nothing affordable about it, and there’s very little care involved, but it is an act.”
But one part of the health reform law he does like is the requirement that consumers can’t be turned down because of pre-existing health conditions.
“Insurance companies have no problem with that, as long as they’ve got enough bodies to be able to have a balance between what they’re taking in and what they’re paying out,” Powell says. “But I don’t think insurance companies are in favor of requiring everybody to have it, either.”
That’s a reference to the individual mandate, which requires all Americans to buy health insurance or pay a financial penalty. Praeger and others have long argued that without the mandate, people would have no incentive to pay for insurance until they get sick and need help paying claims.
She likens it to being allowed to wait until your house is burning to buy homeowners insurance. And contrary to Powell’s claim that insurance companies aren’t in favor of the individual mandate, the lobbying organization for the country’s largest health insurers insisted on the mandate before they would agree to accept all customers — regardless of pre-existing conditions — as part of the ACA.
Despite his misgivings, Powell accepts that educating consumers about the health reform law is one of the insurance commissioner’s duties. But he would change the way that’s done. Currently, the Kansas Association for the Medically Underserved administers a federal grant that funds “navigators” who help Kansans get insurance through the federal health insurance marketplace. The Kansas Insurance Department is one of five organizations in the navigator grant consortium.
“I wouldn’t involve the navigators in any way, shape or form in any of my education process,” he says. “The law says that the insurance departments have no authority to regulate a navigator. That’s outside the purview. And if I can’t regulate a group, then I’m not going to involve them in advertising that they’re available, or what they can do.”
Instead, Powell would steer consumers toward licensed insurance agents for advice and assistance in buying health insurance — either through the federal marketplace or outside the marketplace.
While Powell would like to make the department more business-friendly for companies interested in offering new insurance products, he considers consumer protection the paramount duty of the insurance commissioner. Powell says that view is reflected in his definition of insurance.
“I believe it’s a promise being made to you by the insurance company, and I want to make sure that promise is kept,” he says. “I have worked with, and will continue to work with, insurance companies to make sure that we are bringing in companies that are properly priced, that are financially sound. That’s a part of the job of the commissioner, to make sure that when a claim happens, the claim will be paid.”
Powell and his wife, Lois, have been married for 47 years and have three children and six grandchildren.
As he campaigns for the office of Insurance Commissioner, Powell says a 14-year-old girl asked him why he’s running for this office — but she wanted his answer in only two words.
“For me, that’s pretty simple: ‘I care,’” he says. “Those are my two words. I care about you, I care about your family, I care about your business and I care about the State of Kansas. And that’s the attitude I’m bringing to this office if I’m elected.”
Ken Selzer points to another farm state in laying out his vision for a Kansas insurance industry that best serves consumers.
Iowa, he says, has attracted insurance corporations with its streamlined regulations and colleges and universities that produce qualified workers.
“We could do that here in Kansas,” Selzer says. “We need to have a business-minded, business-focused head of the department who can work with companies so that they are competing every day for consumers’ dollars. That will improve affordability, coverage and availability in the state of Kansas.”
Earlier this year, Athene USA announced that it was shuttering its 200-employee insurance operation in Topeka to consolidate operations at offices in West Des Moines. Des Moines also recently put on a Global Insurance Symposium to showcase the city’s insurance sector and the state’s willingness to work with the industry.
One major inducement for companies to do business in Iowa is a comparatively low tax on premiums written in the state, says Tom Alger, a spokesman for the Iowa Insurance Division.
“Iowa has recognized the value of the financial industry,” he says, “and is not out to make life difficult for an insurance company to operate.”
Selzer, of Leawood, is a certified public accountant with more than three decades of experience in the insurance field. A fourth-generation Kansan, he grew up on a farm near Goessel in Marion County.
He has served on the City Council in Fairway and is now vice chairman of the board overseeing the Educational Foundation of the Kansas Society of Certified Public Accountants.
Under his watch, Selzer says the insurance department would strengthen its Consumer Assistance Division and step up anti-fraud efforts, especially for vulnerable populations such as the elderly.
Selzer pledges to cut red tape, roll back regulations that impede job growth and fight government dictates.
To that end, he opposes the Affordable Care Act, also known as Obamacare.
“Any time we force mandates onto companies, there is a cost associated with those,” Selzer says, “and in the case of Obamacare, huge costs that the taxpayer and businesses are paying.”
The economic effects of the ACA have generated significant debate.
When the Congressional Budget Office earlier this year estimated the law would result in two million fewer American workers in 2017, the finding produced varying interpretations. Democrats argued the report demonstrated the law gives workers the flexibility to take care of personal matters, while Republicans said the figure illustrated the law’s harm on the workforce.
Selzer says he would personally advocate for repeal of the law, but says his response to the ACA as insurance commissioner would depend on which party controls the Senate after elections this fall.
If Democrats retain control, he says, his Kansas Insurance Department would do the minimum required to enforce the ACA as a federal law.
If Republicans take the Senate and retain control of the House of Representatives, Selzer expects the department will be busy implementing changes at the federal level that would delay or overturn portions of the ACA.
Under his leadership, Selzer says, the insurance department would stand ready to educate and advocate for Kansans under either scenario.
Selzer also opposes expanding Medicaid eligibility, which is a component of the ACA designed to cover low-income workers who do not qualify for subsidized health insurance policies.
His preference, he says, is to create jobs so that Kansans can obtain insurance through their employers.
Selzer also welcomes Kansas’ participation in an effort known as the Health Care Compact, which aims to give states more control of Medicare and Medicaid funding within their borders.
In April, Kansas became the ninth state to sign on to the compact.
“I am for anything that brings decision-making to a more local level,” he says.
Clark Shultz is the most seasoned politician among the five Republicans running for Kansas insurance commissioner.
In this era of the political outsider, that’s not the advantage that it used to be. But in a down-ballot race, Shultz is counting on the experience factor to give him an edge over his competitors for the GOP nomination.
“The strength that I have is an 18-year legislative history and 10 years of being insurance chairman in the House,” Shultz says. “I’ve really dealt with every conceivable issue.”
Asked for an example, Shultz says he was “heavily involved” in crafting legislation that protects policyholders if their insurance carrier becomes insolvent.
“It doesn’t grab headlines, but it’s a very important piece of technical legislation,” he says. “I have scores of those types of issues where I’ve been there.”
Shultz, a title insurance agent, lives in McPherson with his wife, Lori. The couple have six children.
In addition to the Legislature, Shultz, 57, has served on a school board and as a member of the McPherson County Mental Health Advisory Committee.
After 17 years in the House, Shultz was selected last year to fill Jay Emler’s unexpired term in the Kansas Senate when Emler was appointed to the Kansas Corporation Commission.
Shultz’s decision to run for insurance commissioner when incumbent Sandy Praeger announced she would not seek a fourth term wasn’t a surprise. For the last several years, it had appeared to Statehouse insiders that Shultz was solidifying his conservative credentials in preparation for a statewide race.
In the 2014 session, for example, Shultz sponsored an amendment prohibiting Gov. Sam Brownback from expanding Medicaid eligibility to levels authorized by the federal health reform law. The amendment wasn’t necessary because Brownback – a vocal opponent of the reform law – had given no indication that he was preparing to unilaterally trigger expansion. But offering the amendment gave Shultz an opportunity to demonstrate to GOP primary voters that he was willing to take a stand against Obamacare.
Shultz further demonstrated that opposition by supporting a controversial bill to allow Kansas to join with other states in taking control of the federal health care dollars that flow to them. Praeger and officials from several groups, including AARP Kansas, urged lawmakers to reject the measure, fearing that state control of Medicare could jeopardize the benefits of the nearly 450,000 Kansas seniors enrolled in the program.
Several Republicans joined Democrats in opposing the bill, but Shultz voted for it, explaining that he didn’t think it would affect Medicare benefits.
“I don’t think that is the intention of the compact,” he said moments after the vote. “If I thought it was, that would cause me great concern. We can back out if we see danger signals.”
Understanding that he would need the support of conservatives to win the primary but moderates to defeat Democrat Dennis Anderson in the fall, Shultz sought endorsements from members of both wings of the Republican Party. And he got them. Conservative Congressman Tim Huelskamp endorsed him. So did Praeger, one of the few Republican elected officials in Kansas to support the Affordable Care Act.
Announcing his endorsement on Twitter, Huelskamp said: “Clark Shultz is a strong conservative candidate for insurance commissioner. Clark has extensive experience in the insurance industry and is the best candidate to steer us through the disastrous harm that Obamacare has caused our healthcare system in Kansas.”
Shultz’s effort to woo conservative voters gave Praeger second thoughts even though the politician in her understood why he was doing it.
“It is very difficult because of all the litmus tests you have to pass to get through the Republican primary,” she says. “I know I couldn’t be elected in the current environment.”
Praeger, who also has expressed support for Anderson, the lone Democrat in the race, says she decided to stick with her endorsement of Shultz in the GOP primary because of the working relationship she formed with him when he chaired the House Insurance Committee.
“That’s a good background to be insurance commissioner,” Praeger says. “From the standpoint of the primary, he’s probably the best qualified in terms of understanding what the department does.”
As he campaigns, Shultz works to maintain his balance on what amounts to a political tightrope. He reached out to conservatives when the U.S. Supreme Court ruled against requiring businesses to cover contraceptive services in the Hobby Lobby case by tweeting: “Victory for religious freedom.”
But when discussing the insurance department’s role in educating consumers about the Affordable Care Act, or Obamacare, he sent a signal to moderates by conceding that the law is unlikely to be repealed any time soon and that he’s committed to educating consumers and helping them navigate their choices.
“I will be very strong on making sure we help Kansas consumers whatever the issue is,” he says.
And despite his sponsorship of the Medicaid amendment, Shultz says he is open to the kind of private-sector approach to expansion that some Republican governors are taking. They are attempting to use federal Medicaid dollars to help low-income adults purchase private coverage.
“I think the private sector approach is probably the only approach that would be considered in Kansas,” Shultz says.
In interviews, Shultz shifts the discussion away from controversial issues, preferring to talk about his experience and how it has prepared him to lead a regulatory agency that must balance the needs of insurance companies and consumers.
“We do have to strike a balance,” he says. “But I’m there for the consumer. That is the reason the department exists; to make sure they (consumers) are getting what they are paying for from insurance companies.”
The Gossage profile was written by Dave Ranney, senior writer/editor with KHI News Service, an editorially independent reporting program of the Kansas Health Institute; the Powell profile was written by Bryan Thompson, a reporter for Kansas Public Radio; the Selzer profile was written by Mike Sherry, a health reporter for the Hale Center for Journalism at KCPT; and the Shultz profile was written by Jim McLean, executive editor of KHI News Service.