January 19, 2007

The Missouri General Assembly had a short work week as the legislature adjourned for Martin Luther King Day and did not convene until late Tuesday.

As the Speaker had not yet named committee members the House had no hearings this week.

The Senate began public testimony on the departmental budgets. The Governor will not release his budget until the January 24th State of the State Address. Consequently, the hearings are provided more as a courtesy than offering substance proposals.

As of Thursday, the House was still debating the makeup of the House Committees. The Speaker has proposed a 5 Republican to 3 Democrat memberships. Needless to say the Democrats are not pleased with this ratio.

Filibuster On Nominee… More Of Things To Come?

The Missouri Senate experienced its first filibuster of the session on Thursday, with Senator Matt Bartle (R-Lee's Summit) taking the floor to oppose the confirmation of Warren Erdman as a University of Missouri Curator. The Senate Gubernatorial Appointments Committee voted Mr. Erdman's appointment out of committee on Wednesday, sending the appointment to the floor of the Senate for approval. Senator Bartle explained his filibuster on the floor as a matter of personal affront, citing Mr. Erdman's political actions opposing his re-election as the major and distinguishing reason for his opposition to the appointment. Mr. Erdman, an executive with Kansas City Southern Railroad, is a proponent of stem cell research, while Senator Bartle is the leading opponent of such research based on his position that it would permit human cloning. According to statements on the floor of the Senate, Mr. Erdman supported Rep. Bob Johnson in his attempt to unseat Senator Bartle in his August primary re-election effort.

After sustaining the filibuster for approximately 17 hours (from 10:30 a.m. Thursday until 3:25 a.m. Friday) hours without a restroom break, Senator Bartle was overcome with exhaustion and the Senate quickly moved to approve the Erdman appointment.

Political observers believe that this is a pre-curser to several other major issues of the 2007 session, including the Governor's priority bill relating to the sale of MOHELA assets. This is the first round of several issues that may relate to stem cell research. It is also the earliest filibuster that can be remembered in recent history.

Update On Medicaid Transformation

The transformation of the Medicaid program from a system of automatic payment based on eligibility to a technology-driven, high-quality health program focused on personal responsibility and wellness promises to be one of the thorniest, yet most essential projects of the 2007 legislative session. The Medicaid program, as we know it today, expires next year unless extended by law.

Gov. Blunt this week reiterated his support of a cornerstone of the proposed MO HealthNet – the designation of a "health care home" and a case manager for every participant in the program. For most folks the "health care home" will be a Federally Qualified Health Center (FQHC) or community health facility. Last year, Gov. Blunt agreed to $60 million over six years to enhance and expand FQHCs. This week, he upped the ante by pledging all $60 million this year if the legislature approves his Lewis and Clark Discovery Initiative, commonly known as the MOHELA deal. This would be accomplished through a supplemental appropriations bill, separate from the usual supplemental budget the legislature passes each year. Gov. Blunt has also committed to an additional $5 million for a critical Healthcare Information Technology Initiative, which will allow all the "health care homes" to be connected through a web-based portal. Prescriptions, for instance, will be issued electronically, allowing for the accurate crosschecking of medications and cutting down on the amount of prescription fraud.

A small working group of legislative leaders and representatives from the governor's office continue to ponder other ideas for Medicaid reform, including the tough issue of reducing the number of uninsured individuals in Missouri, currently estimated at 691,000 at any given time. One idea is to require the purchase of health insurance, much as car insurance is required, and subsidize the premiums for those that can't afford it. Finding the pool if money for the subsidies, though, is much easier said than done.

It is anticipated that additional details on Governor Blunt's plan will be made public next week, as he gives his State-of-the-State address on Wednesday evening.

State of the State Address

Governor Blunt will deliver his State-of-the-State and Budget address on January 24 at 6:00 p.m. The address will be televised on certain stations. Attorney General Jay Nixon has been tapped to provide the Democratic response and State-of-the-State following Governor Blunt's address. Nixon has declared his intention to run for the office of Governor in 2008.

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