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Name: AARP
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Missouri End of Session Wrap-Up

The 2009 Legislative Session
 
Health Care

 

Background:
At the beginning of the session, Governor Jay Nixon proposed increasing health coverage in Missouri through two programs.
 
Missouri Legislative Action:
CHIP
The Governor proposed decreasing the premiums paid by families who have their children enrolled in the state Children’s Health Insurance Program (CHIP) and increasing funding for outreach and enrollment. Through the Federal SCHIP Reauthorization Act, required state funds would have been less than $23 million. Unfortunately, this idea fizzled in the House and never recovered in the Senate.
 
MO HealthNet Expansion for Parents
While the proposed CHIP expansion would have cost very little General Revenue, the Governor worked with Missouri hospitals to do even better on the expansion for custodial parents. Through an increase in the Federal Reimbursement Allowance (FRA), the health providers would pay the State’s share for the expansion up to 50% of the Federal Poverty Level. Since this expansion only required spending authority, it was included in the Governor’s State Budget.
 
Show Me Healthcare
Senator Tom Dempsey (R-23) sponsored Senate Bill 306, the legislative vehicle for Show Me Healthcare. The legislation included a framework for a multi-year expansion in coverage for lower income adults. 
 
Unfortunately, Show Me Healthcare was bogged down in the House and changed from a Medicaid program with Federal matching dollars and FRA to an expansion of the High Risk Pool, which would have neither funding source.
 
After several tries by the Senate to urge the House Majority to take up the issue, the final vehicle for expansion was not brought up in the House on the final day of the regular session – and virtually died because of inaction.
 
 
Utilities
Background:
Everyone cares what next month’s utility bills may be, but for people who live on a fixed income, a spike in their utilities can be a life changing event.
 
Missouri Legislative Action:
CWIP
AmerenUE proposed a repeal of the statute passed by voters that does not allow companies to increase their rates up front to pay for the construction of a power plant. The utility company proposed using the statute change to pay for a new nuclear power plant in Calloway County. 
 
The repeal, along with the many other provisions of the bill, would have moved all the risk for construction of the plant from AmerenUE and to their customers. It was estimated that this risk shift would have increased electric rates between 20%-40%.
 
Working together with other utility customer groups, AARP was able to prevent passage of the repeal of CWIP.
 
Budget
Background:
At the beginning of the Legislative Session, House Budget Committee Chairman Allen Icet (R-84) was determined to not use Federal Economic Recovery Funds in the State Budget. This led to a House Budget that included hundreds of millions of dollars of cuts to core services.
 
Missouri Legislative Action:
The Senate Appropriations Committee, led by Senator Gary Nodler (R-32), first divided Federal funds into two separate state funds called the Budget Stabilization Fund and the Economic Stimulus Fund. Through use of the Budget Stabilization Fund in the State Budget, the Senate restored many of the House Budget cuts.
 
The Conference Committee discussion on the Budget came down to one major contentious item: language for Healthcare expansion.
 
The Senate supported allowing the funds to be used either to expand coverage through a MO HealthNet expansion or through the Show Me Healthcare program included in SB 306. The House supported only allowing funding through SB 306.
 
The first compromise position, which contained the Senate language, was reached without the support of the House Republicans on the committee and went to the House Floor for approval. The House rejected this compromise on mostly partisan lines. Only four Republicans: Representatives Denny Hoskins (R-120), Scott Largent (R-38), Ryan Silvey (R-141), and Jay Wasson (R-141); and all Democrats voted in favor of the Senate language.
 
Upon failure of the first Conference Committee Report, a new report was issued that required passage of SB 306 before the funding would be made available. 
 
The House Republicans did not grant a Conference Committee to work out the differences between the House and Senate versions until there was insufficient time left in session to approve a report.
 
 
Voter ID Requirements
Background:
Photo ID requirements for voting create obstacles for groups of otherwise eligible voters, including persons who are older, low-income, disabled, minority, foreign-born or geographically isolated. Many people neither own nor drive a car and thus lack drivers’ licenses. When alternative state-issued ID cards are offered, mobility, language and other difficulties can limit people’s ability to get one. 
 
Missouri Legislative Action:
House Joint Resolution (HJR)9, introduced by Representative Stanley Cox (R-118), would have amended the Missouri Constitution to require a state-issued photo ID to vote – with no exceptions.
 
After several weeks in committee, the sponsor introduced new language that allowed people born before 1941 and people with disabilities to vote a provisional ballot if they could not show photo identification. However, identities would then be verified by matching signatures on file. This was a concern because signatures change drastically over time and obviously, signatures on file with election authorities could be decades old.
 
HJR 9 was voted out of the Elections Committee but was never brought up for debate on the House Floor.
 
Bottom line: not passed.
 
TABOR and Fair Tax
Background:
TABOR, a spending and revenue cap that was passed in the State of Colorado, has become synonymous with failed fiscal policy.  In Colorado, TABOR led to drastic cuts across the board - education, higher education, healthcare, and transportation all suffered. All of this in a state that started from a significantly better fiscal position than Missouri is currently in.  
 
Missouri Legislative Action:
The so-called “Fair Tax” proposal would have eliminated the state’s income tax and replaced the funding with a tax on every good or service purchased in the state. This tax would have extended to health services, long term care, and even utility and phone bills. The Missouri Budget Project estimated that in order to fill the void from removing the income tax, this new tax would have to be at least 10%.
 
Both of these proposals had a wide range of opposition and at the end of session, they both languished in the Senate Ways and Means Committee where no votes were taken.
 
 
Senior Investor Protection Act
Included in the Omnibus Crime Bill was the Senior Investor Protection Act. This act, sponsored by Senator Tim Green (D-13) and supported by Secretary of State Robin Carnahan, will deter and punish those who attempt to defraud seniors.
 
The act creates a penalty of $50,000 for investment fraud committed against seniors over the age of 65, or people with disabilities. It also allows for restitution of the lost funds and a civil penalty of up to $5,000.
 
 
 
 
Missouri Housing Trust
Background:
When the housing crisis hit Missouri, there was only one state program to prevent foreclosures and homelessness, but that program, the Missouri Housing Trust Authority, had been under-funded for over a decade.
 
Missouri Legislative Action:
Senator Jolie Justus (D-10) introduced legislation to correct this problem by adding a $7 fee charged when purchasing property. Due to strong opposition by the Association of Realtors, Home Builders Association, and mortgage bankers, Senators worked out a compromise to lower the fee to $2. The opposition from the Association of Realtors continued.
 
In Conference Committee with the House, the fee was dropped to 50¢. The lobbyist for the realtors, however, still opposed this increase and the entire bill was killed on the House floor.
 
 
Preneed Funeral Products
Spurred by the implosion of a St. Louis business, National Preneed Sellers (now under FBI investigation) Senate Bill 1 established licensing and contract requirements for preneed funeral contract sellers, providers, and seller agents, was passed this year.
 
Under this new law, companies offering prearrangements for funeral services must keep enough cash on hand to meet 85 percent of their commitments.
 
 
Added: May 22, 2009
Views: 1792 | Comments: 5 | Bookmarks: 1

State Issues:

Budget/Healthcare
The State Budget was finalized this week. 
 
The week started with the Conference Committee sending language that would allow an expansion of Medicaid either through passage of SB 306 or through a straight Medicaid expansion.  Seven of the 10 conferees signed the report, all 5 Senators and the 2 House Democrats.
 
On Wednesday, the House took up the Conference Report.  Several advocacy groups and the Governor's offices worked most of the day trying to round up enough votes to approve the report.
 
The floor debate was incredibly heated with the Speaker often calling for order and threatening to clear the House.  Accusations of impropriety were flung at the proponents by the opponents and votes swung between the two sides throughout the day.
 
In the end, the House voted down the report in a 75-85 vote.  All of the House Democrats and four Republicans voted in favor.
 
That evening, the Conference Committee went back to work on a new compromise.  The final report changed the language to only allow expansion through SB 306 - essentially passing the decision on to another Conference Committee. 
 
Steven Tilley, the Majority Floor Leader in the House said immediately after the meeting that he will work to pass SB 306 out of the House on Monday so that there will be adequate time for conference.
 
Housing
As reported earlier, Senator Jolie Justus has added an increase of $2 in the fee that funds the Missouri Housing Trust Fund in HB 376.  That bill will be going to Conference Committee next week.
 
Preneed Funerals
AARP was involved in the Preneed Funerals working group over last interim.
 
SB 1 just passed with some stronger consumer protections.  The AG's Office, AARP and Silver Haired Legislature worked with many funeral home owners/directors and preneed third party sellers to reach some compromise on stronger consumer protections.

Food Security
HB 156, a bill that would increase the minimum amount of food stamps for low income seniors, was heard in the Senate Committee on Seniors and Families this week.  We will be working to get the bill passed from committee before the end of session.
 
Added: May 13, 2009
Views: 168 | Comments: 0 | Bookmarks: 1

Summer vacation may be approaching fast for Missouri school kids, but your AARP Missouri volunteers will be working hard on an advocacy blitz to improve the health care system. Keeping Medicare strong for current and future generations is a top priority. We want to lower costs for people on Medicare, while also eliminating waste, fraud and abuse that squander money, and result in medical errors and poor care.

Skyrocketing costs and our economic crisis are pricing millions of beneficiaries out of the care they need. Medicare patients now spend an average of 30% of their incomes on out-of-pocket health costs -- six times more than those with employer coverage
 
These runaway health costs burden families and the Medicare program itself. To address them, AARP supports an array of actions to contain costs, attack waste and make care more efficient. For example, AARP is also fighting to reduce unnecessary rehospitalizations among Medicare beneficiaries. A recent study found that one in five people on Medicare who leave the hospital have to go back within 30 days, and about one-third have to go back within 90 days. These unplanned and often avoidable readmissions cost Medicare $17.4 billion in 2004.
 
A way to reduce them would be for Medicare to establish a follow up care benefit that helps patients transition home safely after a hospital stay. Under such a benefit, a team of health professionals could establish an individual plan for each patient, to make sure he or she gets adequate follow-up help -- including medication management and education -- to thrive after discharge to home or another facility.
 
These common-sense health reforms are not likely to be enacted without AARP’s leadership. We need your support and your voice to convince Congress to act on them. So please sign up today at www.healthactionnow.org.
 
 
Added: May 13, 2009
Views: 139 | Comments: 0 | Bookmarks: 0

AARP has made guaranteeing access to affordable health coverage for people aged 50-64 an essential element of health reform. Why?  Americans aged 50-64-- who make up nearly half of AARP’s 40 million members -- are taking a hard hit in these times of shrinking employer-sponsored health coverage. They have become the fastest growing group of uninsured. The rate at which they have been losing coverage is really alarming -- 36 percent between 2000 and 2009. And, now, in today’s turbulent economy, as more working men and women in this age group are losing jobs with employer-sponsored health care, they are finding it more and more difficult – if not impossible -- to get affordable individual coverage.

This is -- in large part -- because health insurers consider age and pre-existing conditions when setting their rates. Seven of every ten Americans in this age group have at least one -- if not several – such chronic health conditions as diabetes and heart disease. Insurance industry data show that insurers reject between 17 and 28 percent of all applications from people aged 50-64. And those “lucky”enough to find individual coverage must pay, on average, premiums that average three times higher than premiums for those of the same age who have employer coverage. And their out-of-pocket spending for health care is more than twice that of those with employer coverage -- despite less generous benefits. This problem is becoming more serious because, thanks to the aging of the baby boomers, our 50-64 population is growing rapidly. Nearly one of every five Americans will be 50-64 by 2015.

So, AARP is pressing Congress to find a common-sense solution to the coverage gap for 50-64-year-olds. For information on AARP’s efforts to help people in this age group – and on ways you can help – please check out our new web page for health reform –

www.healthactionnow.org

 

Added: May 5, 2009
Views: 175 | Comments: 0 | Bookmarks: 0

Utilities

With CWIP now dead, Ameren is pouting.  They have tacked an unpopular surcharge onto an energy efficiency bill that AARP and KCP&L worked out a compromise on.  AARP, KCP&L, and several other groups are now working to strip the language back off the bill.

Another issue that has arisen that concerns us is the uncollectible surcharge for gas companies included in SB 299.  This legislation would allow the gas utilities to pass the cost of uncollected rates on to the rest of their customers without oversight from the Public Services Commission.
 
AARP has been working with the gas companies to develop a compromise position that includes income considerations for lower-income ratepayers.
 
Budget
The State Budget is currently in Conference Committee.  All of the numbers in the Budget were finalized this week.  All that remains is the language for the Medicaid expansion.

The language for that expansion has become increasingly important since the Senate included funding for either Senator Dempsey’s SB 306 or for a straight Medicaid expansion through the current MO HealthNet program. 
 
There are several reasons why the language may still be open.  SB 306 has been loaded up with 70 new sections in the House so the Hospital Association who had agreed to pay the match for the expansion may now oppose that legislation or Senators may be concerned about getting the Conference Report passed in the House since that body has rejected the expansion in several votes.
 
In either case, the fact that the funding remains in the Budget is most important, but we hope that health coverage for these lower-income Missourians will not be reliant on passing a now contentious bill through the process.
 
Health Care
Senate Bill 306 , sponsored by Senator Dempsey , has been changed drastically in the House.  The new version has over 200 pages and is full of every good, bad, and ugly health care idea the House has passed in the last two years. 

The bill is almost certain to die under its own weight in its current form.  This may make it essential that the Budget Conference Committee pass a report that includes funding for a straight Medicaid expansion.
 
Voting Rights
HJR 9 was not heard on the House Floor this week, and I’m not prepared to pass on any more rumors, since they continue to be proven wrong.  If the measure is perfected next week, AARP will have a letter ready that will be released the same day opposing the resolution.  We’ll keep you posted.
 
TABOR
Again, no news is good news when it comes to HJR 23, the TABOR Amendment.  No further action has been taken by the legislature.

HJR 36, the so-
called the “Fair Tax” had a hearing in the Senate Ways and Means Committee this week.  There were several proponents who spoke on the bill and a lot of opponents.  Many diverse business interests spoke of the damage such a tax would do to the Missouri economy.  There was so much testimony that they will continue the hearing next week.

The House also approved their misguided $1 billion tax cut this week.  While it is obvious that such a reckless move will be opposed by the Senate, it is troubling that the House continues to pass these measures.
 
Added: May 4, 2009
Views: 153 | Comments: 0 | Bookmarks: 1

AARP urges anyone with flu-like symptoms—including fever, body aches, runny nose, sore throat, nausea, vomiting or diarrhea—to contact their health professional to find out if they should be tested or treated for seasonal influenza or swine flu.

  • You can help prevent the spread of swine flu and other illnesses by:
    • Washing your hands regularly with soap and water;
    • Covering your mouth and nose when you cough or sneeze;
    • Avoiding touching your eyes, nose and mouth;
    • Avoiding contact with sick people; and
    • Staying home from school or work if you feel sick.
  • While we encourage all older Americans to get an annual vaccine for seasonal flu, the swine flu strain is not prevented by the seasonal flu vaccine.
  • The Centers for Disease Control have important information about swine flu available at www.cdc.gov/swineflu.
We encourage people to take personal responsibility for their health with preventive measures—like flu shots—to guard against illness and disease. Keeping people healthy is more efficient and economical than caring for people after they get sick.
 
  • People 50+ are more vulnerable to the flu and its complications, so anyone 50 or older should get a flu shot. You can find a flu shot clinic at AARP.org/flu.
  • A growing number of Americans are caregivers. This sandwich generation needs to get immunized to prevent serious disease for themselves and also for the people they care for—grandchildren and older parents.
  • In a 2007 AARP survey, we learned nearly half of 50+ Americans skipped their flu shot. Many mistakenly believed the vaccine could give them the flu.
  • This is also a good time to ask your doctor about a vaccine for pneumococcal disease, which causes 4,800 deaths annually. Everyone 65+ should consider a pneumococcal vaccine.
Added: April 30, 2009
Views: 146 | Comments: 0 | Bookmarks: 0

State Issues:

 
Utilities
SB 228 is said to be dead by the proponents of the bill .  Naturally, we will continue to track the issue and ensure that the language is not added to another bill. 
Thank you for all of your efforts on this issue.  We faced an uphill battle against this issue, but it looks as if we will be successful.
 
Budget
WOW!  The Budget battle has become very interesting. 
The House had introduced four extra budget bills that were meant to appropriate the remaining economic recovery money from the Federal Government.  After floor debate and several amendments, the majority leadership is now saying that they will scrap the bills and introduce a new bill to give the money out in a $1 billion tax rebate.
The Senate still has the majority of the federal funds in their version of the State Budget Bills so we will certainly be headed for an interesting conference committee.
Many legislators and in-capitol advocates now believe that we will be headed for a special session on the appropriation of these funds since there doesn’t seem to be much common ground between the two bodies on how to spend the money.
 
Health Care
 
 
 
Voting Rights
HJR 9   was not heard on the House Floor this week, but it is rumored that it will come up next week. With the wide range of problems in this bill and new opposition the current language has picked up, we are hopeful that this resolution will have difficulty getting through the process this year.
 
TABOR
Again, no news is good news when it comes to HJR 23, the TABOR Amendment.  No further action has been taken by the legislature.

A new resolution, HJR 36, has been working its way through the process.  This Constitutional Amendment, called the “Fair Tax” by proponents, would tax the purchase of every good or service – including health services and long term care – in lieu of the current income tax.
The Missouri Budget Project estimates that in order to supplant the revenue from the current income tax, this tax would have to be over 10%.   HJR 36 has been referred to the Senate Ways and Means Committee .
 
Housing
Senator Jolie Justus was successful in adding and amendment to HB 376 that would add a $2 increase in the fee that funds the Housing Trust Fund.  Senators from both parties have pledged to help protect the new funding if the bill goes to conference committee.
Added: April 28, 2009
Views: 141 | Comments: 0 | Bookmarks: 0

US Representative JoAnn Emerson paid a visit to Dexter Wednesday morning to drop in on the O.A.K.S. Senior Center, where volunteers with the AARP have been busy providing free tax service to area residents for the past several weeks.

 Daily Statesman article

Added: April 17, 2009
Views: 140 | Comments: 0 | Bookmarks: 0

State Issues:

 
Utilities
At the request of several Senators, AARP has been participating in negotiations with AmerenUE and several other stakeholders in the Senate CWIP bill.  The second meeting was this week and there will be another meeting this coming week. 

AARP, along with several other ratepayer groups, provided a list of requests to improve the legislation.  AmerenUE did not seem willing to make any concessions; in fact, their representatives seemed to believe that the current Senate bill –
SB 228 – went too far in protecting ratepayers.
 
Budget
The Budget bills were finalized by the Senate this week.  The Budget Bills have now been returned to the House for their approval or rejection.  In all likelihood, the House will reject the changes and a conference committee should be assigned next week to work out a compromise between the two positions.
 
Health Care
 
The Senate version of the State Budget includes funding for either this proposal of the expansion of traditional Medicaid proposed by Governor Jay Nixon.
 
Voting Rights
HJR 9 has yet to be scheduled for the House Floor, but several problems with the Committee Substitute have become apparent to many Representatives. 

By putting exception language into the State Constitution, several currently acceptable voting methods would no longer be allowed.  Military personnel serving overseas would not be allowed to vote by mail since they would be required to show photo identification.  Voters on the permanently disabled list would not be allowed to vote by mail either and would now be required to have their ballots notarized. 
 
It is also unclear whether legislation that has spurred as much controversy as Photo Voter still has enough time to work its way through the process.
 
TABOR
No news is good news when it comes to HJR 23 , the TABOR Amendment.  No further action has been taken by the legislature.
 
  
Federal Issues:
AARP participated in two town hall meeting about Health Care Reform hosted by Representative JoAnn Emerson this week.  Ron Sergent was the AARP spokesperson in Kansas City and Ilena Aslin was the spokesperson in St. Louis.
 
Added: April 17, 2009
Views: 150 | Comments: 0 | Bookmarks: 0

State Issues:

 
Utilities
 
Senate Bill 228 , the bill often referred to as CWIP (Construction Work In Progress) is a piece of legislation that purports to allow AmerenUE to build another power plant in Calloway County by increasing rates charged to consumers.
 
AARP, along with other consumer protection groups and industrial customers, has been urging the General Assembly to not pass this legislation that would increase rates in the middle of an economic recession for jobs that will not appear for years to come.
 
 
This legislation was heard on the floor of the Senate on Tuesday.  Senators spoke on the bill for over 10½ hours until the sponsor finally laid the bill over until the proponents and opponents could work out a compromise.
 
Senators Crowell , Callahan , Bray , Mayer , and Justus participated in opposing this legislation during the floor debate.   
 
Budget
The Budget bills have been finalized by the Senate Appropriations Committee.  Included within the Senate version of the Budget is an expansion of Medicaid, funding for home delivered meals, and an increase in funding for home and community-based services.

The Senate Budget will be debated on the Senate floor beginning next week.
 
Health Care
The Senate has included the funding mechanism for the Governor’s Medicaid expansion proposal.  This funding mechanism will allow the state to expand coverage by increasing the “provider tax” for hospitals and not use any of the State General Revenue.  The Hospitals have agreed to increasing this fee as long as it goes to expanding services.
 
Voting Rights
HJR 9 , a resolution that would require voters to show a photo ID was passed from the House Election Committee this week. 

Many legal Missouri voters do not have access to a state-issued photo ID or would find it onerous to be required to get one.  Many elderly Missourians and people with disabilities do not drive and therefore have not taken the many steps necessary to maintain a photo identification.  The Secretary of State’s office estimates that this Constitutional Amendment would disenfranchise over 200,000 Missouri voters when there have been no reported cases of voter impersonation.
 
This legislation could come up for discussion on the House floor as early as next week.
 
TABOR
HJR 23 , often called “TABOR”, is a constitutional amendment that would limit state spending to the rate of inflation and the increase in population.  While this sounds like a good idea, state spending does not work the same way as household spending.  The state spends a significant amount on health care for the most vulnerable and education – which have increased at rates much higher than the rate of inflation in recent years. 
 
A similar proposal in Colorado so severely damaged the state’s ability to fund needed programs and attract businesses that Colorado voters have overturned many of the restrictions contained within the amendment.
 
This legislation had a hearing in the Senate Ways and Means Committee this week, but the sponsor failed to appear for the hearing.  It is thought that it will not get another hearing this session.
Added: April 14, 2009
Views: 135 | Comments: 0 | Bookmarks: 0