Revenue Estimate passes out of Senate Tax Committee

The Montana Senate Taxation Committee unanimously passed the bill containing the state’s revenue estimate on Friday. The estimate is used as a basis for state spending. Lawmakers from a joint House/Senate Committee have been meeting to discuss the estimate provided to lawmakers from the Legislative Fiscal Division.

The revenue estimate passed by the committee is a little more than $4 billion over the next two year budget cycle. The Senate Taxation Committee also unanimously amended the estimate $30 million higher during their Friday meeting, due to adjusted figures from the Legislative Fiscal Division.

Another amendment to add an additional $30 million to the estimate failed on a party line vote. This additional $30 million would have moved the figure closer to the higher estimate provided by the Governor’s Office of Budget and Program Planning, which uses a different method for predicting revenue.

Sen. Christine Kaufmann

Senator Christine Kaufmann (D-Helena) says the process of coming to the revenue estimate is a good one that resulted in a good starting place, but it could be better. She thinks economic factors studied by the Governor’s Office show revenues coming in stronger than what has been previously anticipated and she thinks that will keep happening throughout the session.

“We could have added a little bit more money to the estimate, and I think that would provide us a little more room for whatever we might need in terms of investing in public education and other services for Montana,” she said.

Sen. Ron Arthun

Republican members of the Taxation Committee say the revenue estimate could be off either way, positive or negative. Senator Ron Arthun (R-Wilsall) say the more conservative estimate will lead to less spending and “if the revenue comes in at a greater amount, there will just be more in the coffers for the next session.”

The revenue estimate now moves up to the full Senate for a vote next week. If passed, it moves over to the house.

Health professionals tell lawmakers about priorities

A collection of healthcare professionals in Helena are outlining priorities for state lawmakers.

The group met over breakfast Tuesday.

Proposed Medicaid Expansion will likely dominate the Legislative session beginning in January.

The attendees of this early morning breakfast chose from large pans of scrambled eggs, tater tots and bacon. Sitting in a large conference room in St. Peters Hospital, they talked healthcare.

The hospital sponsored the event along with the County Health Department, and other health organizations like tobacco use prevention groups.

They took turns speaking to two Democratic lawmakers; another Democrat and Republican weren’t able to make it.

When the mic comes around to Helena Democratic Senator Christine Kaufmann, she makes clear her focus for the legislature.

“The biggest impact of anything we do this session is to cover uninsured people,” she said, referring to the decision the legislature will make on whether or not to expand Medicaid coverage.

Medicaid Expansion is a provision of the Federal Affordable Care Act. An upfront payment of $5 million by the state would trigger federal funds to cover about 80 thousand new Medicaid patients in Montana.

Democratic Lawmakers are expressing support but many Republicans are not on board yet. Some GOP legislators have characterized Medicaid Expansion as an unreliable and expensive overreach of the federal government.

It’s a divisive discussion, and Helena Democratic Representative Jenny Eck believes it will be at the forefront of the legislative health debate.

“It’s a big choice we have to make as a state and it’s not a choice we can ignore,” Eck said, “But I do think we have to remember there’s a lot of ways to address our healthcare crisis.”

And that’s where most of the attendees at the breakfast came in, not talking about Medicaid expansion but a whole host of other things. Mental Health Services, the Childrens Health Insurance Program, and so on. A lot of the discussion revolved around wellness, which is what St. Pete’s Radiologist Dr. Jeff Georgia was talking about. He started by walking over to the breakfast pans.

“Turns out the cafeteria food is fat laden,” he said, “we’ve got bacon and eggs and tater tots.”

There is also a bowl of fruit, but Dr. Georgia says he’d like to see the healthy food dominate a breakfast like this. He says every dollar invested into programs promoting wellness and preventive care saves around seven dollars in healthcare costs for patients later.

“The problem in the Legislature tends to be that the things that are the most dramatic get the most funding and sick people with coronary artery disease, that’s a dramatic presentation,” Georgia said.

Lewis and Clark County Health Officer Melanie Reynolds agrees.

“You know, that is always a challenge for the public health community, for us to talk about something that will have benefits way down into the future,” Reynolds said.

But she says those types of bills will still be a priority.

“We’re looking at legislation that makes the healthy choice the easier choice for citizens,” Reynolds said.

A priority that will have to likely stand in the shadow of Medicaid Expansion.

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BOTH SIDES: LR 122, prohibiting the government from mandating the purchase of health insurance

We’re looking into the last of three legislative referenda appearing on the November ballot. These are measures referred to the voters by the state legislature.

The full first clause of LR 122 says, “an act prohibiting the state or federal government from mandating the purchase of health insurance coverage or imposing penalties for decisions related to the purchase of health insurance coverage.”

(SEE FULL LR 122 LANGUAGE HERE)

I don’t know if this rings any bells, but it should. It’s probably the most controversial element of the Patient Protection and Affordable Care Act, otherwise known as “Obamacare.”

This referendum has run into a little bit of a hitch though.

“It really has no impact whatsoever,” said Helena Democratic State Senator Christine Kaufmann.

LR 122 was drafted before the US Supreme Court issued its ruling on the Affordable Care Act. That June ruling declared the US Constitution does allow the federal government to mandate the purchase of health insurance coverage. And a law passed by the voters of Montana cannot overrule that.

So in some ways, LR-122 would effectively be a statement from the people.

Republican Speaker of the Montana House of Representatives Mike Milburn says it’s an important one to make. He says the Federal Government mandating to states is becoming more common.

“States should have certain rights and when we see those being encroached upon, we need to push back,” Milburn said.

Democratic State Senator Christine Kaufmann does support the Affordable Care Act, so she wouldn’t want to make that statement. But she says this kind of gesture is pointless anyway.

“It’s an exercise in futility,” she said. “Why should we spend all this emotional energy saying ‘get out of the way federal government, we can handle this ourselves’ when we’ve never been able to handle healthcare ourselves and it’s going to be a meaningless solution.”

LR 122 would be unconstitutional the moment it passes. But, a lawsuit would need to be filed against this new Montana Law and the law would need to be declared unconstitutional by a judge. That ruling could then be appealed, so on and so forth. These things take time.

Meanwhile, if Mitt Romney wins the Presidential election, he has vowed to do everything he can to repeal ObamaCare. Say Romney wins and gains enough Republican support in the House and Senate, repeal is possible. If that repeal happens before LR 122 is declared unconstitutional, then it would no longer be unconstitutional.

MILBURN: “So, it’s still very applicable and we’re hoping it will pass just to send that message,” Milburn said.

Another indication that the fight over health care reform is far from over.

This story uses excerpts from my Montana PBS special on the ballot measures, “From the People: Montana’s 2012 Ballot Measures”

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