Mo. House Passes ‘ Medical Conscience’ Bill
February 12, 2014

(AP) – Missouri health care workers could refuse to partake in certain medical procedures that violate their ethical or religious beliefs under legislation endorsed by the Missouri House on Wednesday.

The House voted 116-38 to give first-round approval to the bill, which is sponsored by Republican House Speaker Tim Jones. He said the measure would protect workers from having to engage in procedures that conflict with their beliefs, while also protecting patients.

“This is good for patients in making sure they don’t have people involved in their procedures making second guesses because of their religious beliefs,” said Jones, of Eureka.

Republican Rep. Keith Frederick, an orthopedic surgeon from Rolla, agreed and said it was important that medical personnel are engaged with the patient rather than worrying about religious conflicts.

The measure would apply to procedures such as those involving abortion-inducing drugs, artificial insemination and the withdrawal of nutrition and hydration. It would also let workers opt out of procedures involving cloning and embryonic stem cell research. Religiously-affiliated hospitals would be shielded from liability for refusing to provide medical procedures that conflict with their religious beliefs.

It would require health care workers to give “reasonable” notice to their employers if they are going to opt out of a procedure. Health personnel also could not be fired or demoted for refusing to participate in an operation. The legislation would not permit workers to withhold emergency treatments that could save a patient’s life.

AP’s 5 Take Aways from the Missouri SOTS
January 22, 2014

1. DOLLARS AND CENTS

Lawmakers and the governor disagree about how much Missouri will have in the treasury to spend for the 2015 fiscal year. Legislative budget leaders agreed to a state revenue estimate used as a foundation for developing the budget, but the governor did not sign off on it. Lawmakers have said their estimate is $8.59 billion; Nixon’s office is using an estimate of $8.74 billion. The split means the Legislature is likely to look for places to cut from Nixon’s budget proposals.

2. SCHOOLHOUSES

Nixon is proposing a $278 million increase in basic aid for public school districts, which would move Missouri halfway toward covering an estimated $566 million shortfall of what’s called for under a state funding formula. Missouri currently provides about $3 billion annually for school districts. The governor also proposed nearly $30 million of funding increases for early childhood education and additional funding for higher education. That would include a $42 million increase for public colleges and universities distributed based upon whether they have met performance goals, nearly $20 million for schools to train more mental health professionals and a roughly $28 million increase for college scholarship programs.

3. TOUGH SELLS

Nixon is renewing his push to expand Missouri’s Medicaid health care program to more lower-income adults and to restore caps on campaign donations. Both were featured in the governor’s State of the State speech last year and neither received a warm reception from the Legislature.

4. POMP AND CIRCUMSTANCE

The State of the State address is delivered before a joint legislative session in the House chamber. Governors enter the chamber through a set of double-doors in the rear, walk down the center aisle shaking hands and speak from the House dais. Previously, the speech was given during the day, but it has been held in the evening since 2005. Among those attending the speech are members of the Missouri Supreme Court, agency directors and guests specifically mentioned and introduced by the governor during his address.

5. THE REBUTTAL

House Speaker Tim Jones said in the Republican response to Nixon’s speech that Missouri needs a tax cut to compete economically with neighboring states. He said Nixon wants more of Missouri residents’ tax dollars to increase spending and grow government and Republicans will not let that happen

Money for Schools at Center of Nixon’s SOTS Soeech
January 22, 2014

(AP) – Missouri Gov. Jay Nixon proposed a nearly half-billion-dollar spending surge for public education Tuesday as he urged lawmakers to harness the revenues generated by an improving economy to make up for years of funding shortfalls for schools.

The Democratic governor proposed a $278 million increase in basic aid for public school districts, plus millions of more dollars for preschool programs, student scholarships and state colleges and universities.

As he delivered his sixth annual State of the State address to a joint session of the House and Senate, Nixon said Missouri’s elected officials had built a solid budgetary foundation through tough economic times and with “our economy picking up steam” now face “a defining moment for our state.”

“On the campaign trail, I’ll bet almost all of us made a promise to invest in our students and our schools,” he told the Republican-led Legislature. “Well, you know what? It’s time to put our budgets where our campaign brochures are.

“Now it’s time to decide whether we’re merely going to talk about public education, or whether we’re going to fund it,” Nixon added.

The governor’s record-high $27.7 billion budget plan could set up an election-year showdown with Republican lawmakers who want to use part of a projected budget surplus to cut income taxes for Missouri businesses and residents.

House Speaker Tim Jones, who delivered the Republican response, said a tax cut is vital for Missouri to compete economically with neighboring states that have recently enacted their own tax cuts.

“Instead (Nixon) wants to take a page right out of the Washington, D.C. playbook. He wants more of your hard-earned tax dollars so that he can increase spending and grow the size of government,” Jones said.

Jones, R-Eureka, vowed that Republicans “will not allow this to happen on our watch.”

But Nixon, who vetoed tax-cut legislation last year, maintained an equally firm stance Tuesday.

“I will not support anything that takes money out of our classrooms,” Nixon said.

Missouri currently spends a little over $3 billion annually in basic aid for public elementary and secondary schools. The governor’s proposal would move Missouri halfway toward covering a projected $556 million shortfall of what’s called for under a state school funding law.

Although Republican lawmakers expressed support for schools, they questioned Nixon’s optimistic budget forecast and said they will have to cut his proposed spending. As Nixon outlined his education initiatives, Republican lawmakers generally sat silently while Democratic lawmakers and educators packing the public galleries repeatedly stood to applaud and cheer.

“He made a lot of promises to a lot of people in this budget that I’m not sure can be fulfilled,” said House Budget Committee Chairman Rick Stream, R-Kirkwood.

As he did last year, Nixon again called on lawmakers to expand Medicaid eligibility to lower-income adults, which would allow Missouri to reap an influx of federal dollars under President Barack Obama’s health care law. But Republicans who repeatedly rejected such proposals last year have shown no inclination to change course.

Republicans cheered when Nixon acknowledged that the federal government’s implementation of the health care law “has been abysmal.” Then Democrats applauded when Nixon added: “But rejecting Medicaid won’t fix any of those things

Nixon Expected to Push Education in State of the State Speech
January 21, 2014

(AP) – Gov. Jay Nixon was expected to propose a significant funding increase for Missouri’s public schools when he outlines his budget and policy priorities Tuesday during his annual State of the State address.

The Democratic governor was likely to present an optimistic vision of Missouri’s economy, which he contends will generate more revenue than Republican legislative leaders have projected.

Nixon said he will make “a very strong case for how the best economic development tool we have in this state is education, and how at this defining moment for our state that we should not miss the opportunity to make the strategic investments that will pay dividends for our state for generations to come.”

The governor has said he wants to fully fund Missouri’s school formula before his term ends in three years. The state currently provides about $3 billion annually in basic aid for K-12 schools, but that’s still about $600 million short of what’s called for under state law.

A surge in state tax revenues could allow Nixon to propose hundreds of millions of new dollars of education spending. Much of that could be focused on elementary and secondary education, but part also could go to early childhood education and public colleges and universities.

As a prelude to his speech, Nixon already rolled out more than $80 million of proposed funding increases for higher education, including a $36.7 million performance-based increase in state aid for the operating budgets at public universities. He’s also proposed increasing scholarship funding for students who agree to work in Missouri after graduation and expanding classroom slots for students in mental health fields.

Some of those proposals could gain support from Republicans, but others could be reduced by legislative budget writers. House Speaker Tim Jones, for example, has said he supports increased funding for scholarships but doesn’t want “just to blindly increase the size and scope of government.”

Republican legislative leaders want to tap an expected budget surplus for an income tax cut, which they have made a priority for the 2014 session. Nixon vetoed a tax-cut plan last year

Nixon’s Medicaid Plan Looks In Trouble Again
January 6, 2014

(AP) — Medicaid expansion remains a priority for Gov. Jay Nixon as Missouri lawmakers open their annual legislative session this week. Yet the prospects of that occurring appear slim.

Like last year, Missouri’s Democratic governor and Republican legislative leaders are entering the session with a wide rhetorical and ideological gap on the question of whether Missouri should expand Medicaid eligibility to thousands of lower-income adults.

Republican lawmakers, who have instead called for Medicaid “reform,” may even have trouble agreeing on what that should entail – raising the potential that no Medicaid legislation gets passed during the session that runs from Wednesday through May 16.

Missouri’s Medicaid program currently covers more than 850,000 people.

Nixon’s administration estimates an additional 300,000 – many of them uninsured – could eventually be added to the program if Missouri takes advantage of a federal health care law that pays extra money to states that raise adult Medicaid eligibility. Missouri would have to cover adults earning up to 138 percent of the poverty level, an annual income of about $32,500 for a family of four. The state currently cuts off eligibility at less than $4,500 annually for that same family.

Twenty-five other states already have expanded Medicaid eligibility and will be getting the bonus payments this year.

Nixon lists a Medicaid expansion among his top priorities for the legislative session.

“Let’s resolve to pass a bill that brings our tax dollars home to strengthen and reform Medicaid,” Nixon said last week.

But Medicaid expansion didn’t even make the list of more than a dozen priorities that House Speaker Tim Jones outlined in an interview last week. Jones, R-Eureka, called the federal health care law a “disaster.”

“The governor’s really on the wrong side of history continuing to beat the dead horse of Obamacare and Medicaid expansion in our state,” Jones said.

Jones and many other Republican lawmakers have suggested that Missouri should first “reform” its Medicaid program before expanding eligibility