Republicans and some Democrats at a state House budget subcommittee meeting have continued to question Governor Jay Nixon’s blocking of some spending in the state budget, much of it from the departments of Health, Mental Health, and Social Services.

Representative Marsha Haefner chairs the House Appropriations Committee on Health, Mental Health, and Social Services (photo courtesy; Chris Moreland, Missouri House Communications)

Representative Marsha Haefner chairs the House Appropriations Committee on Health, Mental Health, and Social Services (photo courtesy; Chris Moreland, Missouri House Communications)

Nixon said he must withhold $46-million in the state budget because Missouri won’t get $50-million in tobacco settlement money he and lawmakers had expected. He says the restrictions are necessary to keep the budget balanced and protect the state’s AAA-credit rating.

Jennifer Tidball with the Department of Social Services said the money was meant for what would have been new programs. She tells lawmakers the restrictions mean the “status quo” will continue.

“What the programs would have been designed to do was – that individual who’s now accessing the emergency room, providing them another avenue of care, for example, besides the emergency room. That’s just an example,” Tidball said.

Social Services Director Brian Kinkade suggested a theory about why the restrictions hit the programs they did.

“Because the restriction was tied to the Tobacco Settlement funds and the Tobacco Settlement funds are appropriated to Medicaid, then all else equal, the Medicaid program has a $50-million hole in it, at this point,” said Kinkade.

The restrictions will mean a one-percent raise for some health care providers participating in Medicaid rather than three-percent. Tidball explained the Department measures that affect in terms of access for patients.

“Whether or not providers would choose to no longer be a part of the Medicaid system, and thus, our participants don’t have as many choices or can’t get in to see a doctor because we don’t have enough providers,” said Tidball.

Representative David Wood (R-Versailles) said the restrictions will affect foster care even as the state’s children’s division says more foster homes are needed.

“I don’t understand why we would take a provider cut in a program that is essential to the state, that is going to effect the children in the state, and when you have a director calling for increases, isn’t there other places we could have taken this money that would have had less of an effect?” Wood asked.

Republicans say they might attempt to overturn those restrictions if they are still in place in January. They argue the state has a budget surplus right now and say that makes the restrictions unnecessary and unconstitutional.

Earlier stories:

Missouri governor announces budget restrictions in response to tobacco settlement ruling

Missouri legislative Republicans call Gov. Nixon’s budget restrictions ‘unnecessary’