health care exchange Archives

Attorneys argue whether health exchange issue ballot summary is biased

August 20, 2012 By Mike Lear

The arguments presented over a temporary restraining order give the first glimpse of attorney’s cases on whether or not the Secretary of State was biased in a ballot summary.

Cole County Courthouse, Jefferson City

The question is, is the language used by Secretary of State Robin Carnahan to summarize a ballot question about blocking state elected officials from creating a state healthcare exchange without voter or legislative approval, biased?

It reads: “Shall Missouri law be amended to deny individuals, families, and small businesses the ability to access affordable health care plans through a state-based health benefit exchange unless authorized by statute, initiative or referendum or through an exchange operated by the federal government as required by the federal health care act?See our earlier story on the hearing on the temporary restraining order.

The attorney representing Carnahan’s side, Jeremiah Morgan, says that accurately represents the intent of the bill passed by the Republican-led legislature.

“There’s no question that efforts are being made to undermine the federal Affordable Health Care Act. Whether we as a policy matter or a political matter agree with or do not agree with, that’s what Senate Bill 464 attempts to do and this summary is attempting to do that.”

Attorney Jay Kanzler, representing several GOP elected officials, says Carnahan wrote “obvious” bias into the summary.

“Secretary of State Carnahan’s language, talking about denying families and individuals access to affordable healthcare, frankly doesn’t even come close to describing what the ballot issue would do.”

The attorney representing the Secretary of State’s Office, Jeremiah Morgan, says the Republicans’ lawsuit only looks at part of the ballot summary.

“They skipped this important language, as it says, ‘through a state-based health benefit exchange.’ So it says families, small businesses, so forth will not have the opportunity to have a formal health plan through a state-based exchanged, unless passed by the legislature or unless passed by referendum, or through a federally based plan, and that’s exactly what Senate Bill 464 does.”

Kanzler argues that when one looks at the ballot issue as a whole, it becomes more confusing.

“It says ‘deny individuals, families and small businesses the ability to access affordable healthcare through state-based health benefit exchanges unless authorized by statute, initiative or referendum … so you’re saying deny that or deny the second part. Mr. Morgan lays out there that this is in fact clear. It’s not clear.”

Kanzler maintains that the summary is misleading.

“This initiative does not ‘deny.’ It gives the voters … the people of Missouri a choice to either vote in state based health insurance exchanges or accept federally based healthcare exchanges.”

A summary judgement hearing in the case is scheduled for August 28. Cole County Circuit Judge Dan Green has taken the motion for a temporary restraining order under advisement.

Republicans to file court challenge to health exchange ballot language

July 5, 2012 By Mike Lear

Lieutenant Governor Peter Kinder doesn’t like Secretary of State Robin Carnahan’s ballot language for an issue related to the federal health care law, and he says he’s going to fight it in court.

Lieutenant Governor Peter Kinder and Secretary of State Robin Carnahan

The issue would bar the Governor from creating a health insurance exchange as related to the Affordable Care Act unless lawmakers or voters give him that authority. Kinder says the summary Carnahan has released to describe that issue on the November ballot is misleading.

“No direct costs or savings for state and local governmental entities are expected from this proposal. Indirect costs or savings related to enforcement actions, missed federal funding, avoided implementation costs, and other issues are unknown.”

Kinder says, “To use the very active verb ‘deny’ individuals, families and small businesses the ability to access affordable healthcare plans is outrageously biased. On its face it’s biased. I have not talked to anyone who believes it’s fair.” He says the language is worded “as though the Obama White House had written the language to illicit from Missouri voters a negative result.”

Kinder says he’ll file a lawsuit challenging the wording, “if not Friday then early next week at the latest.” He adds that House Speaker Steven Tilley (R-Perryville) and Senate Majority Floor Leader Tom Dempsey (R-St. Charles) have already committed to joining that suit.

Kinder says he won’t use public money for the suit, adding he doesn’t anticipate any problems getting private dollars to back it.

Carnahan’s office, in a statement, says “This office has always followed our legal obligation to provide Missourians with fair and sufficient summaries of ballot initiatives, and this summary is no different.”

Secretary of State Spokesman Ryan Hobart adds, “we feel it confident it will hold up in court,” and points out the state legislature had an opportunity to write its own ballot language and did not.

House Republicans say ‘no’ to $50 million federal grant

March 26, 2012 By Mike Lear

The Missouri House of Representatives has turned down a $50 million dollar grant from the federal government for its connection to the Affordable Health Care Act.

Representatives Ryan Silvey (left) and Chris Kelly (photos courtesy, Missouri House Communications)

An amendment offered during budget debate would have authorized the Department of Social Services to use that federal grant to upgrade its computer systems. Budget Committee Chairman Ryan Silvey (D-Kansas City) told the body the purpose of the grant is to set up a health insurance exchange. “What we’re trying to do with this amendment is enact Obamacare through the backdoor and call it a computer upgrade. I simply can’t support that.”

Silvey also criticized Governor Jay Nixon, saying his administration had applied for this grant after the legislature failed to pass a health insurance exchange bill, with plans to spend it outside of the legislature. Silvey says the administration was asked to include the matter in the supplemental budget, or in a governor’s amendment during the normal budget process, neither of which happened.

Instead, Silvey says the legislature received a letter from Budget Director Linda Luebbering about the grant. “When the Governor wanted to give $40 million to higher ed from the mortgage settlement we got a governor’s amendment. When he wants to spend $50 million on a backdoor Obamacare, we get a letter from the budget director. So I made the decision that as much as I enjoy the budget director and the job that she does, that she doesn’t get to make amendments to the budget and so I didn’t put it in.”

House Democrats argued against turning down the money. Representative Chris Kelly (D-Columbia) said the money is not necessary to have a health care exchange. “There is nothing in the law or the regulations that requires the health care exchange for this to happen. Nothing at all … The fact of the matter is our computers are falling apart and we could fix this problem with this money.”

Kelly agreed with Silvey’s criticism of the Governor for not sending an amendment and conceded that the grant would upgrade the computers the federal government would use to establish a health insurance exchange. He disagreed with Silvey that the goal is to pave the way for the health care exchange. “The computer system takes care of all our healthcare whether there is an exchange or not.”

Democrats argued unsuccessfully that some of the money could be used to fill other budget needs, such as the $28 million dollar supplement for the blind that was eliminated in the House’s budget plan.

Representative Jill Schupp (D-Creve Coeur) told her colleagues, “That’s my money. That’s my constituents’ money. That’s our taxpayer dollars that we can utilize to improve our computer systems regardless of whether anyone in this room is willing or unwilling to accept the fact that the Affordable Care Act may just be coming down the pike.”

The amendment was defeated 52-98, mostly along party lines.