Wednesday, February 14, 2018
JACKSON Rep. Cheikh Taylor, D-Starkville, stepped to the podium for his first time ever last week to offer a significant amendment to the House Medicaid legislation. Instead of offering drug treatment for opioid-addicted Medicaid beneficiaries, Taylor's amendment would allow any Mississippian on Medicaid suffering from addiction to any drug listed in two parts of the state's illegal drugs schedule to receive services.
"This amendment will reduce recidivism and allow our men and women to be with their families to be back in homes for treatment," Taylor told the House.
At first, Republican Rep. Gary Staples, R-Laurel, requested a fiscal note on the amendment, which would have essentially killed the attempt. However, he withdrew his request after he saw that Republicans actually supported the measure.
Rep. Jason White, R-West, who is largely responsible for writing the House's Medicaid bill, supported the amendment and asked the House to vote for it.
The move signals a bipartisan recognition that previous "War on Drugs" strategies, like penalizing crack cocaine but not powder cocaine in the 1980s and 1990s, are not effective, acknowledging that addiction exists beyond opioids, as Taylor noted.
Democrats wanted the Medicaid bill to include an amendment to create a fund to direct federal Medicaid funds to certain health-care providers serving low-income people throughout the state. Rep. Robert Foster, R-Hernando, made a motion to table the amendment, effectively killing it.
The House proposal, unlike the Senate proposal, would require the Division of Medicaid to re-bid out the three recently approved contracts for managed-care companies in the state, meaning the state could choose to not fund Molina's contract, forcing the Division of Medicaid to re-bid them out in 2019.
White said he heard from several Houses members that the most recent bidding process was not fair. Molina Healthcare is set to come on as the state's third managed-care company in October.
"The cry was that the process was not fair. There's a new director of Medicaid that I have great confidence in—there's a breath of fresh air," White said. "... This is this body's will."
Drew Snyder, former deputy chief of staff for the governor, is the new director.
Rep. Jarvis Dortch, D-Jackson, questioned what kind of precedent the state would set by mandating that the contracts be re-bid, noting the current litigation against the Division of Medicaid.
After some debate, the House passed its technical amendment legislation by a vote of 108 to 3.
The Senate Medicaid debate did not enjoy the same kind of bipartisan showmanship. Democrats decried a part of their bill, which is also partially in the House version, that allows the governor to reduce certain services, reduce reimbursement rates or take other measures if the Medicaid division is projected to spend more than the amount of state funds appropriated to it.
Senate Democrats cried foul at these provisions because the Division of Medicaid has declared a budget deficit every year since 2014.
"Does that mean the governor can do anything he can with this Medicaid bill notwithstanding anything else?" Sen. David Blount, D-Jackson, asked during debate.
Senate Bill 2836 leaves discretion of what to reduce in terms of "unnecessary costs" up to the governor and the Medicaid director.
The Senate Medicaid bill, like the House proposal, allows more doctor visits and prescriptions. Unlike the House bill, the Senate approved a measure that allows the Division of Medicaid to enter into a contract with a technology company to develop population health and data analytics. The Senate version also includes the creation of a commission to study expanding the state's managed-care program.
Senate Democrats voted against their Medicaid technical amendments legislation, citing the potential overreach the legislation gives the governor.
"We are directing him to gut Medicaid and give it away," Sen. Willie Simmons, D-Cleveland, said.
Given the differences between the two versions, changes to the state's Medicaid program will likely go to conference, and members from the Senate and House will have to compromise next month before lawmakers approve a final proposal.
'School Choice' Dead For Now
The push for voucher expansion in Mississippi appears dead for now. After thousands of dollars from inside the state and beyond helped fund lobbying efforts and lawmaker dinners in 2017, the push to expand vouchers died on the Senate calendar. Lt. Gov. Tate Reeves did not take Sen. Gray Tollison's, R-Oxford, bill up for a vote. Reeves blamed the House for killing the bill, however.
"Unfortunately, Senate Bill 2623, which expanded access to educational savings accounts to more parents and students, did not survive today's legislative deadline because there is not enough support in the House at this time," Reeves said in a press statement.
"We need to continue to educate legislators, in both chambers and in both political parties, on the success Mississippi parents have seen in the current ESA program and how 'school choice' will have long-term benefits to our state."
Supporters of using tax money for private-school vouchers and charter schools call those practices "school choice."
Reeves refused to expand on his sentiments to reporters on deadline day, but Tollison chalked the bill dying up to the House as well as what typically happens to a new idea in the statehouse.
"There was zero evidence that the House was going to consider the bill, but we've been the tip of the spear on several ed-reform efforts. You know, it took how many years, six years to pass significant charter-school legislation?" Tollison told reporters last week.
"I think we get this out there and get a conversation started and get people familiar with the concept, and it takes time. That's not unusual for new, innovative legislation to go through several sessions before it's considered or before it's successfully passed."
When House Speaker Philip Gunn, R-Clinton, learned that Reeves blamed the House without taking the measure up for the vote in his own chamber, he said, "I don't understand that logic."
Tollison claims he had the votes in the Senate to pass the bill, but we likely will not know until 2018, unless a lawmaker figures out how to amend legislation that is still alive to include some language from Tollison's bill.
More Gun Bills
Despite public colleges and universities protesting against House Bill 1083, Gipson brought forward a measure that would allow Mississippians with enhanced concealed-carry licenses, who must take a certified instructional course, to bring declarative lawsuits against public entities with policies that go against state law.
The bill would also make any public agency's policy about carrying concealed firearms "have no force and effect" for those with enhanced licenses.
Some House Democrats expressed concerns about the measure, but Gipson pointed out that much of the bill is already state law and has been since 2011.
The House overwhelmingly passed the bill, and it will now go to the Senate for consideration.
Email state reporter Arielle Dreher at [email protected] and follow her on Twitter for updates from the Capitol at @arielle_amara.