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Two House Republicans’ letter seeks to sway Nixon on transfer legislation

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Two Republicans who have crossed party lines to work on Medicaid expansion say Governor Jay Nixon (D) needs to heed his own advice and work across lines to not veto the proposed transfer bill.  They have written a letter to Nixon on the issue.

Representative Jay Barnes (R-Jefferson City) and Representative Noel Torpey (R-Independence) say Nixon has in more than one State of the State Address called for working across political, geographical and other lines to solve problems. Barnes says that’s what they’re asking him to do with the transfer bill.

“That’s exactly what happened with Senate Bill 493,” says Barnes. “You saw a bill that the Senate passed 29-3, the House passed it with a bipartisan majority of 89 votes – obviously a little bit closer – but this is a bill which required a lot of work, a lot of compromises all around.”

See Barnes’ and Torpey’s letter to Gov. Nixon

Torpey says the bill isn’t perfect, but he wants to work with Nixon in the interim and next session to address the problems the governor has with the bill rather than see it vetoed.

“Education is such a complicated issue like Medicaid. I think it’s important to work together and to go forward,” says Torpey, “but to simply just blow a bill up, I don’t think that’s the right approach.”

Nixon says he can’t support a bill that would allow tax dollars to go to private schools. Barnes says that would make him like “legislative absolutists,” who make progress on key issues impossible.

The pair write, “Instead of insisting on a bill which is “perfect” to you, we ask that you read the bill as a whole. If you do, we believe you will find that the private option is only a small portion of the bill – a portion we believe is vital and necessary, but a small one nonetheless.”

Barnes says Medicaid and the transfer bill are similar in that both will require compromise, but he and Torpey both say their letter is not to suggest that they won’t work with Nixon on Medicaid if he doesn’t do what they want on the student transfer bill.

Legislature approves $26.3-billion budget for FY 2015

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The state House and Senate have approved a $26.3-billion operating budget for the fiscal year that begins July 1. The proposal goes to Governor Jay Nixon (D) for his consideration the day before the legislature’s deadline.

House Budget Committee Chairman Rick Stream. (photo courtesy; Tim Bommel, Missouri House Communications)

House Budget Committee Chairman Rick Stream. (photo courtesy; Tim Bommel, Missouri House Communications)

Legislators based their spending proposal on a projection revenue in Fiscal Year 2015 would grow by 4.2-percent. Nixon’s administration projected growth at 5.2 percent in the budget proposal he presented the legislature in January. Because of that disagreement the legislature proposes drawing money for some state programs and services out of a new surplus revenue fund, where money that comes in beyond its revenue projection would go.

The proposal would increase funding to public school districts by $114.8 million, but if Governor Nixon’s higher projection proves accurate, K-12 education would get an additional $278-million on top of the current $3.1-billion in state support.

Either outcome would put state support for education below the amount needed to fund schools as required by state law. That would require an increase of more than $550-million.

Representative Margo McNeil (D-Florissant) criticized the decision to go with the lower revenue projection, and says the budget does not go far enough for education.

“We should have decided for a higher number. We should have prioritized education more,” said McNeil. “I’m going to be voting against this budget because basically we’re not putting our priorities where we should be.”

Representative Mike Thomson (R-Maryville) says the budget includes the biggest increases in state history for education and higher education.

“We have gone way above what was expected, I think, for education funding,” said Thomson. “This body gets accused a lot of picking on education, of not fully funding the formula and not doing the best we can, and I would like to point to these numbers and say this is a very good effort, the best we could do.”

Public colleges and universities would get an increase of $43-million to be distributed based on the meeting of performance goals.

The legislature has built into the budget a plan to pay for the replacement of the state’s only maximum-security mental hospital, Fulton State Hospital. The 25-year bonding proposal would cover the cost of buidling the new hospital, estimated at $211-million. The first payment on those bonds of $14-million is included in the proposed budget.

See our earlier story on the legislature deciding on Gov. Nixon’s plan to fund a new Fulton hospital

It also includes $1.5-million for renovation of the Women’s Building at the Missouri State Fairgrounds in Sedalia and $2-million to rebuild levees protecting Rosecrans Air National Guard Base in St. Joseph.

The plan includes an across-the-board 1-percent pay raise for state employees. Child abuse caseworkers within the Department of Social Services would get an additional two-to-three percent increase in salary, as part of $5.1-million aimed at recruiting and retaining good investigators and improving the state’s response to reports of child abuse.

House Budget Committee Chairman Rick Stream (R-Kirkwood) said of the Children’s Division increases, “That’s one of the most important parts of this budget.”

See our earlier story on the increases proposed for the Children’s Division

The highest “no” vote totals in the House came on the budgets for the Departments of Mental Health, Health and Senior Services, and Social Services, as Democrats objected to those bills not including expansion of Medicaid eligibility using federal dollars.

Representative Judy Morgan (D-Kansas City), called that exclusion disappointing.

“I do believe, though, one day the General Assembly will wise up and will rise up and we will vote for Medicaid expansion,” said Morgan. “I just wished it were sooner than later and that’s why I will be voting ‘no’ on this bill.”

Representative Noel Torpey (R-Independence), who participated in a committee that traveled the state taking testimony on Medicaid expansion in the interim, said he hopes that the legislature will act to reform and expand Medicaid.

“I ask that we keep an open mind when discussing this issue in the future,” said Torpey. “At some point in time it’s going to become law, so why not sooner than later?”

The legislature’s proposed budget would increase spending by 6.4-percent, compared to the Governor’s budget proposed in January that would have increased state spending by 11.6 percent.

House Republican Medicaid plan sponsor undeterred by Senate Republican comments

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Work will continue on a House Republican proposal that would reform Medicaid and expand eligibility in Missouri, despite Senate Republicans reaffirming their opposition to Medicaid expansion. A House Committee will hold its third hearing on the proposal, HB 1901 sponsored by Representative Noel Torpey (R-Independence), early Tuesday in the basement of the Capitol.

“There is no path for Medicaid expansion to occur in Missouri this year,” said Brad Lager (R-Savannah) on Monday, one of five Republican Senators who said they would block any attempt to expand Medicaid eligibility this session.

“If we’re going to allow five people to run the state, that’s unfortunate,” says Torpey. He agrees that expansion by itself will not succeed in the Republican-controlled Missouri legislature.

“That was evident last year,” Torpey tells Missourinet, “but if people want reform and truly want reform, we’re going to have to do some type of eligibility changes, and so they’re linked together.”

Torpey says the Senators’ comments won’t cause him to do anything differently.

“Things can change in politics in a day, let alone eight weeks,” says Torpey.

House Speaker Tim Jones (R-Eureka) says the opposition to expansion is not limited to the Senate.

“The signals I’m receiving from the (House Republican) caucus and the signals I’m receiving from the Senate are that expansion is simply something that the legislature does not have much of an appetite for this year,” Jones says. “They’re very concerned about the long-term effects on the budget, and I share those concerns.”

Torpey thinks stripping out the expansion components of his legislation would not be successful either.

“I really think it’s a partnership,” says Torpey of reform and expansion of Medicaid. “We get both or nothing.”

The hearing Tuesday will focus on three aspects of Torpey’s bill, including increased eligibility in some populations.

Earlier stories:

Hearing highlights work requirement, premium in House Republican Medicaid plan

House Republican files Medicaid expansion, reform proposal

Hearings continue on proposed Medicaid reform, expansion plan

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A House Committee will continue its hearings on a Republican proposal for reform and expansion of Medicaid Monday afternoon and Tuesday morning.

The Committee on Government Oversight and Accountability will hear Monday at 2 p.m. the portions of the legislation dealing with health care homes, managed care, and managed care requirements. In a hearing Tuesday beginning at 8 a.m. the committee will discuss the “Show-Me Healthy Babies program,” proposed to provide medical coverage to unborn children through the Children’s Health Insurance Program (CHIP), increases in eligibility, and coverage for high-cost Medicaid recipients with complex medical conditions who would fall under a new category of “medically frail.”

The hearings will take place in Hearing Room 3 in the basement of the State Capitol.

The proposal is HB 1901, sponsored by Representative Noel Torpey (R-Independence).

Earlier stories:

Hearing highlights work requirement, premium in House Republican Medicaid plan

House Republican files Medicaid expansion, reform proposal

Hearing highlights work requirement, premium in House Republican Medicaid plan

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A House Committee has held the first hearing of a Republican proposal for reform and expansion of Medicaid.

Representative Noel Torpey (photo courtesy; Tim Bommel, Missouri House Communications)

Representative Noel Torpey (photo courtesy; Tim Bommel, Missouri House Communications)

The first of three planned hearings to pick apart the bill has focused on reform components. Drawing the most criticism on the day are the proposals of a requirement that Medicaid recipients have a job, be looking for one or be a student, and that participants pay a premium of 1-percent of their income.

Saint Louis University law professor Sidney Watson tells the committee those might not be legal, and says there is a question of whether the secretary of the U.S. Department of Health and Human Services has the authority to grant waivers to allow them to become policy.

“The Secretary has never approved a straight premium charge that results in ineligibility for nonpayment,” says Watson of the premium proposal, “because of concerns that people earning below or near the poverty line can in any given month have problems coming up with those payment charges.”

The bill is written so that if those waivers aren’t both granted, the legislation as a whole would fail. Joel Ferber with Legal Services of Eastern Missouri urges the committee to remove that contingency.

“It just seems like a very potentially not very productive endeavor. I think the key is to either modify these two provisions or to loosen up the waiver provision so if you get 99.9-percent of the waivers you want you can still go forward.”

Committee Chairman Jay Barnes (R-Jefferson City) says he isn’t convinced those provisions would not be approved for waivers, and says they are key to the bill.

“I think it’s only fair that we require an able-bodied person to actually work before they qualify for Medicaid,” Barnes says. “I think Missourians are willing to help those who are willing to help themselves.”

Barnes hopes to have the next hearing on the Monday after next week’s Spring Break, with a focus on more reform components.

The legislation is HB 1901. 

See our earlier story on the legislation.

House Republican files medicaid expansion, reform proposal

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A Republican plan for expansion and reform of Medicaid has been filed.

Representatives Jay Barnes (left) and Noel Torpey (right) were announced as the chairs of 2 House Interim Committees on Medicaid last summer by House Speaker Tim Jones (center). (photo courtesy; Tim Bommel, Missouri House Communications.

Representatives Jay Barnes (left) and Noel Torpey (right) were announced as the chairs of 2 House Interim Committees on Medicaid last summer by House Speaker Tim Jones (center). (photo courtesy; Tim Bommel, Missouri House Communications.

Representative Noel Torpey (R-Independence) has filed the bill after chairing one of two House interim committees on Medicaid last summer. Torpey’s proposal takes a different approach from past legislation in that it would require Medicaid recipients old enough to work to have jobs.

It would extend Medicaid coverage to adults with incomes below the federal poverty level and, Torpey says, it would help people making between the poverty level and 138 percent of the poverty level buy private insurance on the federal exchange.

“Why not help people who are trying to help themselves?” Torpey asks. “From a state’s perspective it’s fiscally responsible.”

Torpey says another key component of the bill is transparency for hospitals.

“We should know what non-life-threatening procedures cost … time after time after time, they don’t want to share that information and that’s unfortunate,” says Torpey. “I think that in itself will help some of the costs in healthcare.”

The lead co-sponsor on the bill is Representative Jay Barnes (R-Jefferson City), who chaired the other of those interim committees and has filed Medicaid reform legislation in the past.

He says another chief difference between those bills and this one is the requirement of at least one-percent of a recipient’s annual income to be paid in a premium for a coverage plan.

“We need recipients to take the responsibility to pay some of their own money for their health insurance,” says Barnes. “Because they make lower incomes that’s going to be a lower amount of money, but I think it’s important that they pay what they can into the system in order to get their own health insurance.”

Legislative staff are still preparing an estimate of the impact Torpey’s bill will have on state revenue, and he believes it will save the state money.
“I’m eager to see how positive it is,” Torpey tells Missourinet.

Torpey’s legislation is HB 1901.

Medicaid Committee Chairman: discussion has shifted to reform plus expansion

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The larger of the two House Committees studying Medicaid expansion and reform has one hearing left.

Representative Noel Torpey (R-Independence) chairs the committee made of up citizens and legislators studying Medicaid eligibility and reform issues. He says the comments his committee is hearing tell him that the conversation has changed since the legislative session.

“People who have testified in person … I would say maybe even 95 percent of them … are for expansion with reforms. I felt like when we brought it up while in session it was really, for the most part, just talking about expansion or not expansion.”

Torpey says some witnesses have reminded lawmakers of significant needs for reform.

He says one example was raised on Wednesday, “Why does Medicaid pay for surgery but not pay for the rehab? Those are important points to bring out. Those are questions we need answered, because that doesn’t make sense.”

The Committee’s final hearing is Wednesday in Chesterfield, after which it will submit a report to another committee made up entirely of House members. 55 people have signed up to testify at that hearing. Torpey anticipates another 20 or more will show up that day to testify. He expects it to last until 6:00 that evening.

House announces two interim Medicaid committees (VIDEO)

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The House Speaker wants your help in finalizing the membership of a committee that will weigh what the future of Medicaid in Missouri should be. 

House Speaker Tim Jones (center) announces an interim committee to be chaired by Representative Jay Barnes (left) and a working group to be chaired by Representative Noel Torpey (right). (photo courtesy; Tim Bommel, Missouri House Communications)

House Speaker Tim Jones (center) announces an interim committee to be chaired by Representative Jay Barnes (left) and a working group to be chaired by Representative Noel Torpey (right). (photo courtesy; Tim Bommel, Missouri House Communications)

Representative Tim Jones (R-Eureka) has announced two new groups to consider Medicaid reform and/or expansion. One of them, the Citizens and Legislators Working Group on Medicaid Eligibility and Reform, will be made up of citizens and legislators taking testimony and other information to be used by the second, the House Interim Committee on Medicaid Transformation when it compiles recommendations to be made to the Republican majority caucus.

Jones wants Missourians to help decide how big the Working Group will be and who will be on it.

“Over the course of the next week my office will take membership recommendations from the general public of the entire state of Missouri for the committee … my hope is that Missourians from all parts of the state will reach out with any suggestions they have for members. We already have an ever-expanding and growing list of interested folks from all different, diverse walks of life and from across the state.”

Jones says he wants that Working Group to dig deep into the details of Missouri’s possible future with the Medicaid program.

“To provide citizen-generated ideas and solutions to a problem that has been often dominated by discussions related to dollar signs and false promises of free money rather than doing what is best for the people who most desperately need this care.”

Jones used the announcement of the committees to re-state his opposition to a simple expansion of the current Medicaid system.

“We see, and I believe Missourians see, expansion without reform as a massive misuse of taxpayer dollars on a program that provides inferior access to healthcare and poor health outcomes … and if we dump hundreds of thousands of additional uninsured people into that system and give them a magical plastic card and simply say, ‘Well now you have free healthcare,’ we will further drive an already broken system into a bankrupt state.”

The Working Group will be chaired by Representative Noel Torpey (R-Liberty) and the legislative interim committee will be chaired by Representative Jay Barnes (R-Jefferson City).

The Senate has also announced an interim committee on Medicaid, and a bill awaiting action by the Governor would create a joint legislative committee on the subject.

 

House to announce Medicaid committees this week

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Two Committees will be announced by the House Speaker this week that will look at Medicaid reform and expansion.

House Speaker Tim Jones (photo courtesy; Tim Bommel, Missouri House Communications)

House Speaker Tim Jones (photo courtesy; Tim Bommel, Missouri House Communications)

The larger of the two will be made up of a mix of representatives and individuals from the private sector that will travel the state and gather information from stakeholders. It will be chaired by Representative Noel Torpey (R-Independence). The other will be made up strictly of legislators and chaired by Representative Jay Barnes (R-Jefferson City).

House Speaker Tim Jones says the second committee will, “take advice and consent from the larger committee and then boil something down into solutions to the issue of Medicaid transformation.”

Jones says it is the latter committee that will be responsible for coming up with suggestions for the majority Republican caucus on how to proceed with the Medicaid issue.

Those on the two sides of the Medicaid expansion debate were split during the session on whether Missouri should expand eligibility to 138 percent of the poverty level. Republicans proposed a plan that called for reform and expansion to 100 percent. Jones says he will leave that issue completely up to the chairmen of the two committees.

“We’re going to have to see what kind of compromise can be struck. I think it’s an open question right now as to whether we only reform Medicaid and do no expansion … or at what level we expand it.”

The Senate has already announced its own 10-member committee to study possible Medicaid changes.

The two committees will be announced on Thursday.

 

House advances voter photo ID bill, constitutional change

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The state House is one vote away from sending the Senate a voter photo ID bill and the change in the state constitution that would allow it to become law.

Representatives Tony Dugger and Stanley Cox (photos courtesy; Tim Bommel, Missouri House Communications.)

Representatives Tony Dugger and Stanley Cox (photos courtesy; Tim Bommel, Missouri House Communications.)

House lawmakers’ emotions ran the gamut during hours of debate on Wednesday. Democrats say passing the measures into law would disenfranchise about 250,000 Missouri voters including minorities, the elderly, women and the military.

Representative Chris Kelly (D-Columbia) made an emotional argument against the proposals.

“Jim Crow is alive in this room today. This is the single most immoral act that I’ve ever seen happen in my time in the general assembly.”

The legislation laying out how voter photo ID would work, sponsored by Representative Tony Dugger (R-Hartville), was advanced 106-48. A proposed constitutional amendment sponsored by Representative Stanley Cox (R-Sedalia) to make the requirement for voter photo ID was perfected 108-46. Two Democrats, Vicki Englund (St. Louis) and Ira Anders (Independence) who voted against the bill voted for the proposed amendment. If both pass the legislature, the latter would go before Missouri voters.

Representative Genise Montecillo (D-St. Louis County) said those who voted yes would have to answer to constituents.

“Every one of you will have constituents who will have their constitutional right to vote taken from them with this bill. I envy you even less going home and explaining it to your families, your children, your grandchildren. Most of all I don’t envy you having to explain it to your maker when you meet your maker.”

Representative Noel Torpey (R-Independence) responded to Montecillo’s comment.

“If I’m going to hell, it’s not because of the vote I take today.”

Republicans say the law won’t disenfranchise anyone and will prevent voter fraud. It exempts anyone 65 and older and allows those who come to a polling place without a photo ID to cast a provisional ballot.

A vote to pass the legislation out of the House is expected to take place today.