Senate Asked to Consider $50Million Addition to Budget by Governor

The past week or two of budget discussions has been spent dealing with the various attempts to implement features of Obamacare in our state. We have made sure our grassroots members have been kept abreast of the discussions.

After declining to provide the House a “Governor’s Amendment” to add $50 million to the budget, Governor Nixon is attempting to take another bite out of the federal funding apple to lay the groundwork for the Obamacare Insurance Exchange. I know it will come as no surprise to you that the Governor’s camp is denying this is an action that will in any way establish the Obamacare Insurance Exchange. This, despite the fact that the name of the grant is “Health Insurance Exchange Establishment Grant.”

You may recall that a couple of weeks ago the Missouri House resoundingly defeated accepting federal funds for this purpose. Governor Nixon’s administration at first could not answer what the funds were really going to be used to accomplish. Their mantra was “upgrading the state’s Medicaid computer system.” Now, to be sure, the computer system does need to be upgraded. The question for legislators is “does not need to be upgraded using federal funds that are intended to lay the groundwork for the Obamacare Insurance Exchange?” The House said no.

The House Budget Chair, Representative Ryan Silvey, had requested what is known as a “governor’s amendment” for the requested $50 million. The Governor refused to issue a “governor’s amendment” explaining the need for the grant to the House. The head of the Office of Administration, Budget and Planning had provided the information about the “upgrading of the Medicaid computer system,” but the Governor could not or would not provide additional information.

Now the Fiscal Year 2013 budget is in the Senate Appropriations committee. Low and behold, a governor’s amendment has been sent to the committee. Traditionally, the Senate has been more friendly to governor’s amendments than the House.

Several Senators, some serving on the Senate Appropriations Committee, were instrumental in stopping the previous attempt by the administration to establish the Obamacare Insurance Exchange. The Senators were successful in stopping the “Cooperative Agreements to Support Establishment of State-Operated Health Insurance Exchanges” grant but it is back in the latest version of “upgrading the Medicaid computer system” — but on steroids!

The grant the Governor is requesting the Senate add to the budget includes all the tasks from the previously mentioned grant such as these mentioned by the application:

“Because the ACA requires a..streamlined enrollment for Medicaid, CHIP….the development of the IT system will benefit Medicaid/CHIP-related programs and Exchange-related programs. Therefore, costs for this project need to be allocated between Medicaid/CHIP and the Exchange. Additionally, the Medicaid program will be building, to varying degrees, supporting infrastructures to facilitate the work of the Exchange.

“We expect the State staff working on the exchange and the supporting Medicaid program activities to similarly work together as they develop joint solutions.” (emphasis added)

Interestingly enough, the link to this information has apparently been removed from state computer systems. ‘Must have been an upgrade!

    EDITOR’S NOTE: After a call from the House Budget Chairman’s office the links are apparently working again.

The Senate Appropriations Committee has the opportunity to once again tell the federal government, ”no thank you” regarding the establishment of the Obamacare Insurance Exchange. They are under pressure as they are being told that “upgrading the Medicaid computer system” will result in the reduction of employees needed by as many as 500 – no word as to whether the employees have been told the same thing. The alleged reduction in the number of state positions necessary to continue the current approach is very tempting to some Senators. However, the Senators must consider if the proposed $100 million total “upgrade of the Medicaid computer system” can be done for less AND without the strings of the Obamacare Insurance Exchange being attached.