May 21, 2009

This session may be categorized for what was not done as opposed to legislation passed.

Federal Stimulus funds turned budget negotiations into disarray.

House Republican leadership promoted several plans including a tax cut and then went on a “pork barrel” frenzy that was defeated by their own membership.

A major education package was defeated in the House and then passed again. Some pundits felt that the education bill did not hurt school districts this year and positives have yet to be determined.

Major legislation dealing with economic development and local government was defeated repeatedly by the Senate. The senate ultimately passed the economic development bill placing caps on historic tax credit programs and several others while increasing the “Quality Jobs Program”. The Governor’s office and House/ Senate leadership declared victory.

In reality, the economic development bill could have placed even more severe restrictions on Missouri’s economic development tools.

Five Republican Senators held off any economic development bills for the entire session until the final two days.

The House also rejected a health plan and held it hostage to an economic development bill until it was passed in exchange for health care expansion.

Governor Nixon promoted legislation to ensure 35,000 working poor at no cost to the state and the House leadership rejected the proposal several times. The Senators enthusiastically endorsed the program.

Although numerous entities pushed for a health care package it was not taken up. Consequently, the House obtained an economic development package without passing the Governor and Senators health care package.

It was very interesting in the new term limit era to see how the legislation is acrimonious among not only different parties, Democrat and Republican, but also among the ruling party of Republicans.

There has been not less of a trend but more of a trend towards one issue special interest legislation.

A group financed by billionaire Rex Singquefield continues to focus the legislative agenda and will ultimately obtain more influence.

This legislative year at a glance:

Sunshine Law
HB 316 was passed by the House and heard in the Senate General Laws Committee.

The bill was amended to address concerns of public entities including reducing and then moving fines for purposefully violating the Sunshine law to current levels.

Although the bill did reach the Senate floor it was “laid over” for future discussion and died.

 We changed provisions for MOALPHA ensuring that sections regarding not for profit organizations apply only to high school athletic associations.

HJR 23 “TABOR like”
HJR 23, a tax limitation initiative based on a doomed Colorado plan from several years ago did not pass.

However it did receive approval in the House before dying in the Senate Ways and Means Committee. Chair Vogel did not move the bill this year. However, Vogel will “term limit” in two years.

Once again, Billionaire Singquefield is pushing the legislation.

SJR 18- Property Tax
This property tax limitation failed this year. However look for it to return as a priority of Senator Jane Cunningham.

This constitutional amendment, if approved by voters, would limit increases in assessed value due to reassessment of real property to the lesser of the percentage increase in the consumer price index for the Midwest Region or two percent until a transfer of ownership occurs. Upon a transfer of ownership, such property would be reassessed at its value for the year in which the transfer occurs.
This constitutional amendment is identical to SJR 4 (2009).

Fair Tax
Another Rex Singquefield group initiative, HJR 36, passed the House and was killed in the Senate Ways and Means Committee.

Look for this legislation to return next session. It basically replaces all taxes in return for an increase in sales tax.

As written it is supposed to be revenue neutral meaning taxes will increase on sales tax from 3% to at least 9-12%.

Tobacco
As reported earlier funding was included for youth tobacco prevention at $1 million. This is a small amount. However, it is a breakthrough.

Presumptive Eligibility
The budget committees did add language for presumptive eligibility at $3.3 million with a $9.86 federal match. This will be of great help for SCHIP patients and the FQHCs.

CORE Funding
MOALPHA should be congratulated on restoring funding this year to our CORE local public health funding.

After numerous phone calls Representatives Hobbs and Dethrow added an amendment restoring funding to $9 million.

Senator Barnitz fought for MOALPHA in the Senate. We are very fortunate not to have lost ground this year. We will need to start early to avoid cuts next year.

Sunshine Law Advances
S.C.S.H.C.S.H.B. 316, the revisions to the open meetings/records law, was passed by the Senate General Laws Committee with several amendments. First, the Committee deleted the mandatory $1,000 penalty and restored the existing penalty of up to $1,000 based on the seriousness of the violation, the size of the jurisdiction, and previous violations of the law. Second, the Committee deleted the requirement that all litigation settlements and awards be disclosed at the next public meeting of the governing body. Third, they modified the notice requirements for a vote on a tax, fee, TIF, NID, CID, TDD, or eminent domain. Finally the Committee decided to delete the mandatory training and certification for all public officials (over 60,000) by January 1, 2010.

The bill did not pass. It was brought up for debate and stalled.

Property Tax
On the last day SB 485 was passed without a provision enabling disgruntled citizens with 33% of the electorate signing a petition to add to the ballot a decrease in property tax.

The ballot language specifies a 66% approval for passage. Once again the Singquefield group! This proposal will return next year.

Immigration
Despite the late date HB 390 was passed on the last day with MOALPHA’s language allowing local public health departments to report E-verify immigrant status of employees annually rather than with every contract revision with the state.

Representative Nolte worked with me to develop the language. As other groups recognized our language it was expanded to include political subdivisions dealing with the state.

This success should prove to result in less paperwork and notarization for our health departments. 

Property Tax
HB 148 was passed. Among its provision was the fix to last year’s SB 711.

The language is from SB 174. This is a major accomplishment worked on by the education and government entities.

The bill corrects errors in SB 711 from 2008.

This is necessary to avoid drastic rollbacks of tax rates next year. The language allows political subdivisions to levy property tax rates for as much revenue as in 2007 plus new construction so long as it does not exceed the most recent voter approved rate.

SB 174 link: http://www.senate.mo.gov/09info/BTS_Web/Bill.aspx?SessionType=R&BillID=549340

Budget
The Missouri Legislature approved:

• House Bills 1 – 13 (the annual operating budget) utilizing $783 million in federal recovery funding,
• House Bill 21 utilizing $2.5 billion in federal recovery funding, and
• House Bill 22 utilizing $381 million in federal recovery funding.

All of these budget bills are on the Governor’s desk. He has the power to veto line items in the budget, but he may not add money to any line item.

Helmet Law
SB 202 was passed with Senator Ridgeway’s amendment allowing motorcycle riders to forego a helmet. Those under 21 will still need a helmet and riders on the interstates will also require a helmet.

Governor Nixon has not yet issued a stance on the bill regarding a veto.

Primary Seat Belts
HB 665, the primary seat belt law, was “loaded up” with amendments in the House Transportation Committee and killed the measure.

Health Care HB 306
The largest defeat this session was the failure of the Legislature to pass restoration of Medicaid eligibility for 35,000 very low income parents with incomes between 20 – 50 percent of the federal poverty level (or an income of $292 - $763) per month. In an attempt to encourage bi-partisan action on increasing access to health care, Senator Tom Dempsey, District 23, proposed SB 306, the “Show-Me Health Plan”. In the final days of the legislative session, Senator Dempsey worked tirelessly with other Senate Leaders including Senators Engler and Shields to support the measure.

The Substitute for HB306 passed by the House was drastically different from the Senate-passed version. Although House and Senate conferees were appointed, it was apparent that the House and Senate would not come to an agreement, and SB306 was not taken up. The House insisted upon healthcare insurers language that stopped the bill. House leadership was also philosophically opposed.

In a last ditch effort on the last day of the session, parts of SB306 were amended to HB156 (Nance), which provided supplemental food stamps for elderly persons. The Senate passed the Senate Substitute for HB156 and sent it back to the House. Unfortunately, the House leadership failed to bring up this bi-partisan measure endorsed by the Senate and the Governor, which would have provided health care to 35,000 low income families at NO cost to the State.

Another loss in health care was the failure of the General Assembly to approve funding for the Governor’s proposal to expand the State Children’s Health Insurance Program.  Ideology and partisanship took precedence over the health care needs of Missouri’s children and families in 2009.

Non Profit Sewer Counties
Another Branson priority was passed by Senator Goodman and Representative Wood.
SB 154 and HB 283 both received approval on the last day.
SB 154 authorizes a nonprofit sewer company to also provide domestic water services, as long as the areas served are not within the boundaries already served by a public water supply district, municipal utility, or water company.

Emergencies
HB 697 did not pass. The legislation added state and political subdivisions employees to the term volunteer for dispensing medications during emergencies.
Dr. Cooper, the sponsor, attached the language to HB 265. However, Senator Crowell, attorney, and the Trial Attorneys fought the bill as they did not want to expand the state legal expense fund.

I worked with DHSS to no avail with Senator Crowell. We will return next year.

Additional

Final Version of SB 306/ HB 156
Below is the agreement worked out by Senate, House and the Governor on the last day.

As reported earlier, the House chose not to bring HB 156 up for a vote. The SB 306 language was amended to HB 156.

Components of SS HB 156

• Creates new standards for privacy of health information
• Evan de Mello for transporting sick children to medical facilities
• Promotes better monitoring of premature infants
• Authorizes medical home diversion project to reduce nonemergency use of ED
• Promotes increase delivery and quality control of telehealth
• Requires MO HealthNet to display publicly de-identified claims data
• Revises standards for MO HealthNet subrogation
• Assist needy elderly with supplemental food stamps, subject to appropriation

Coverage

• Establishes Show-Me Coverage for the following groups, subject to appropriation: 
• Custodial parents with incomes below 50% of FPL (plan amendment, no HSA, paid on an ongoing basis from hospital FRA and DSH)
• Working custodial parents 50-100% FPL (plan amendment, no HSA)
• Working childless adults 20-225% FPL (waiver, HSA)
• Working custodial parents 100-225% FPL (waiver, HSA)
• Uninsurables who meet high-risk pool criteria 100-225% FPL (waiver, HSA)
• Standard Medicaid benefits, plus optical and therapies and without NEMT
• Waiver coverage provided through managed care plans contracted with DOSS
• No time limit imposed on duration of coverage
• Limits copayments for prescription drugs to the retail price
• Requires proof that an adult child qualifies for continuation under parent’s policy
• Standardizes insurance applications
• Expands eligibility for conversion of an employer-sponsored coverage plan
• Reduces period of pre-existing condition exclusion from 12 months to 6 months for group policies
• Creates a state mini-COBRA to follow the federal law
• Allows those age 55 and older to have extended COBRA coverage
• Changes system of premium rating for continuation coverage
• Requires offering of HSA option for continuation coverage
• Modifies Missouri law to track with federal HIPAA law
• Requires employers to offer premium-only cafeteria plan under certain conditions
• Addresses changes in eligibility for the high-risk pool
• Requires the high-risk pool to offer an HSA plan, with guaranteed issue
• Network provider lists to offered in electronic form
• HRA balances may be used to pay for individual insurance coverage
• Dept. of Insurance to study HSA adoption in other states
• Dept. of Insurance to study barriers to entry for new insurance products
• Establishes consistent definitions of “dependent” in insurance laws
• Provides for payment of agents or brokers in the small employer insurance market
• Expands authority to charge reduced premiums for tobacco use in insurance coverage
• Dept. of Revenue to notify parents of potential eligibility for SCHIP coverage of kids
• Emergency clause on mini-COBRA

Conclusion
Term limits have certainly changed the landscape in the General Assembly. In the Senate, Republicans were pitted against each other on economic development and the House seemed to have lost focus in the defeat of the health care plan.

There are numerous interim committees and you will be kept up to date.

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