(Updated April 9th, 11:17 a.m.)
Less than 12 hours after the Missouri Senate passed the Fiscal Year 2016 state budget, the Missouri House has rejected changes made to 12 of the 13 budget bills.
House leaders especially took issue with the Senate version of HB 10, the spending plan for the departments of Health & Senior Services and of Mental Health. The Senate reduced the funding request for several programs within the two agencies by 4 percent and implemented a "lump-sum" funding model.
"The bill from the Senate looks nothing like the bill that (we) sent over to them," said Rep. Marsha Haefner, R-Oakville. "There are some items in that bill that we have worked long and hard to improve in the mental health community, such as behavioral health centers for children and adults, prevention and treatment, our state hospitals, our habitation centers, and our developmentally disabled community...a four percent cut on these programs alone would be catastrophic."
The only budget bill the House and Senate see eye-to-eye on is HB 1, which provides funding to pay off state bonds.
In response, the Senate "refused to recede" from its position, and late Wednesday afternoon appointed eight senators to act as conferees to negotiate final versions on the 12 budget bills they differ on. The Senate conferees are:
- Kurt Schaefer, R-Columbia (Senate Appropriations Chair)
- David Pearce, R-Warrensburg
- Ryan Silvey, R-Kansas City
- Kiki Curls, D-Kansas City
- Gina Walsh, D-North County
- Dan Brown, R-Rolla
- Mike Kehoe, R-Jefferson City
- Mike Parson, R-Bolivar
The House has also chosen its budget conferees:
- Rep. Tom Flanigan, R-Carthage
- Rep. Scott Fitzpatrick, R-Shell Knob
- Rep. Kurt Bahr, R-O'Fallon
- Rep. Genise Montecillo, D-St. Louis County
- Rep. Donna Lichtenegger, R-Jackson
- Rep. Stephen Webber, D-Columbia
- Rep. Gail McCann Beatty, D-Kansas City
- Rep. Lincoln Hough, R-Springfield
- Rep. Jeremy Lafaver, D-Kansas City
- Rep. Robert Ross, R-Yukon
- Rep. Craig Redmon, R-Canton
- Rep. Kimberly Gardner, D-St. Louis
- Rep. Kathie Conway, R-St. Charles
- Rep. John Rizzo, D-Kansas City
- Rep. Marsha Haefner, R-Oakville
- Rep. Jeanne Kirkton, D-Webster Groves
By law, the Missouri House and Senate have to send the state budget to Gov. Jay Nixon one week before the final day of the legislative session.
(Original story)
The Missouri Senate early Wednesday morning passed all 13 bills that make up the Fiscal 2016 state budget, but not before enduring a six-hour filibuster and initially failing to approve the budget for the Department of Social Services.
Trouble with House Bill 11 erupted over language to move 200,000 Medicaid recipients from their current fee-for-service system into managed care. Sen. Rob Schaaf, R-St. Joseph, opposed the move.
"Who is it that wants this? It's these managed care companies, because they're gonna pay their high salaries to their administrators, and that's what this is about," Schaaf said. "I’m just like, amazed that we, the legislature, are doing this, to give these people free money at taxpayer expense without a hearing."
Fellow Republicans Bob Onder of Lake Saint Louis and Ed Emery of Lamar joined Schaaf in blocking the bill. They gave up their filibuster after Sen. Kurt Schaefer, R-Columbia, offered an amendment to forbid any MoHealthNet managed care group from refusing to "contract with any licensed Missouri medical doctor, doctor of osteopathy, psychiatrist or psychologist" located within the provider's geographic area.
Schaefer said those physicians would also "be paid at rates not less than 100 percent of the MoHealthNet fee-for-service schedule."
Schaefer's amendment was approved on a voice vote. However, when the the Senate took up the full bill, several Republicans and most of the Democrats voted "no," resulting in a 17-15 tally, one vote short of the minimum required for passage.
But a second vote was held after fellow Republican Will Kraus of Lee's Summit indicated he would change his position for the sake of moving the bill forward. It then passed by one vote, 18-15.
"We need to try a system where there's some management," Schaefer said after the Senate adjourned. "They get a case manager and there's some oversight over what's actually spent on them, otherwise we're gonna see exactly what we've seen now year after year, which is continued growth in fee-for-service expenses, and it's unsustainable … 6, 7, 8 percent growth every year is eating up every new dollar that we bring in."
Battle over 'lump-sum' budgeting
The managed care debate wasn't the only dust-up between Schaaf and Schaefer Tuesday night.
The two also sparred over the way House Bills 10 and 11 are structured. Schaefer is using "lump-sum" budgeting to fund many of the programs within Social Services and within the departments of Health and Mental Health. Instead of specific dollar amounts for each program within the state agencies, they would have more flexibility over how much money they could hand out. Meanwhile, Schaefer also reduced funding requests by 6 percent for Social Services and 4 percent for Health and Mental Health.
"I'm adamant in the fact that we're gonna rein in welfare growth," Schaefer said.
But Schaaf, who's also a physician, objected to the lump-sum model.
"Which one of these (mental hospitals or habilitation centers) are we gonna cut in order to make the other one whole?" Schaaf said. "State psychiatric hospitals can't take a big cut like that; they have to provide all the health care for their inpatients, their costs of drugs are going up."
Schaefer fired back, "they can't find more efficiency in the ridiculous amounts of overtime that they pay every year?"
Schaaf offered an amendment that would have restored current funding levels for state psychiatric hospitals, habilitation centers, centers for the developmentally disabled, and behavioral health services for children and adults. The amendment failed, though, on a voice vote.
There was less debate on the other budget bills. An amendment to the Higher Education budget bill was offered by Sen. Jill Schupp, D-Creve Coeur, that would have eliminated language barring financial aid to undocumented college students. That amendment also failed.
The state budget now goes back to the Missouri House. Both chambers have until May 8 to send a final version to Gov. Jay Nixon. Republican leaders are trying, however, to pass the state budget by April 30 to force Nixon, a Democrat, to sign or veto any provisions while the legislature is still in session.
That would give the GOP-controlled House and Senate the chance to override any vetoes before the 2015 session ends and would effectively prevent Nixon from rallying support during the summer months for his vetoes to be upheld, a tactic that has worked well for him in recent years.
Follow Marshall Griffin on Twitter: @MarshallGReport
