Three Democratic House members have filed bills to reinstate funding for low income nursing care recipients and providers as well as money for prescription drugs.
Over the summer, Governor Eric Greitens vetoed a bill that finances the nursing care for 8,000 low income seniors by pulling excess money from other state departments. He said the move was unconstitutional and a “last-minute budget gimmick”.
Greitens, in his original budget proposal for the current fiscal year, cut costs by raising the bar to qualify for the nursing care, which removed 20,000 people from its rolls.
House Democrat Deb Lavender of Kirkwood has filed a measure similar to what Greitens vetoed, while addressing concerns over the constitutionality of the provision.
Republicans in the House led by the chamber’s Budget Committee Chairman, Scott Fitzpatrick of Shell Knob, claimed that sweeping excess funds from other departments would be illegal because there was no mechanism to do so.
Lavender’s bill, in and of itself, provides the means for the transaction to take place. Lavender says the money will come from the state agencies that oversee the nursing care and prescription drug programs.
“The majority of the money is coming out of the Department of Health and Senior Services and the Department of (Mental) Health,” said Lavender. “And these are fund balances that have, as an average, about a $5 million resting balance.”
The measures put forth by the three Democrats not only restore the nursing care funding Greitens vetoed, but they also reinstate cuts made to prescription drugs for low income people.
The state contribution to the Medicaid prescription program known as MORx in Missouri was reduced by $12 million in order to help balance the state’s budget this year.
In addition to Lavender’s bill, Democrat Peter Meredith of St. Louis has proposed to slice in half a 2% deduction businesses get when they pay in sales taxes they’ve collected on time. He says the money is better used for the prescription drug and nursing care, rather than on tax breaks which largely go to national big box stores.
“The last thing we want to do is give up another $115 million to businesses that, frankly, most of which goes to WalMart and Home Depot, and a couple of very large out of state businesses that have the large, large tax bills coming due,” said Meredith. “They don’t need the benefit on the backs of our seniors and our school systems, and all of these other places that we’re having to cut.”
Interestingly, the same 2% deduction for businesses that’s the funding source in Meredith’s bill is also a target for complete repeal in a tax proposal from Republican State Senator Bill Eigel of Weldon Spring.
The third Democratic plan to subsidize full financing of the prescription drug and nursing care comes from House member Crystal Quade of Springfield. It calls for Missouri to opt into a streamlined sales tax agreement that other states have already joined which initiates the collection of taxes for online sales. Missouri presently has no such arrangement.
Meredith says the proposal is a common-sense approach to level the playing field for homegrown businesses.
“If you look at all of our local businesses, all of our brick-and-mortar local shops that have to collect as high as 11% sales tax in some places, when they’re having to compete against the Amazons of the world, all of the online retailers that don’t charge any sales tax, that’s a significant disadvantage for our in-state retailers,” Meredith said.
The three bills completely restore funding of Medicaid nursing care while also reestablishing full payments to providers.
That includes $8.1 million for nursing homes, $5.2 million for Home and Community Based Services Providers and $12.8 million for Consumer Directed Services in which a recipient can hire a person of their choosing, sometimes a family member, to supply their nursing care.
The measures generate $35.4 to cover the care itself, and roughly $6 million to replenish prescription drug subsidies for six months under the MORx program.
Lavender’s measure keeps the services fully funded over the next year while the proposals offered by Meredith and Quade supply a long-term source of financing. Lavender’s bill also makes a small cut to a low-income tax credit known as “circuit breaker” She thinks it’s important to look at controlling such costs without diminishing legitimate services.
“In looking at our tax credits, and that’s what I’m hoping we do more of this year, instead of just throwing this one, or removing all of this money from circuit breaker for our seniors, I did take a little bit of money from that,” said Lavender. “But that’s trimming the maximum amount that somebody can use.”
A previous fix to fund the nursing care, and one still favored by Republican Fitzpatrick, involved gutting the circuit breaker credit.
Meredith said the three Democrats have been working together for months to find options for restoring the low income health subsidies.
“These are some really serious, serious cuts that are impacting our most vulnerable citizens, and we thought we had to do something about it,” Meredith said. “We’ve got a long list of ways to restore the funds. So we decided to go ahead and file three bills with essentially our three favorite approaches.”