IALN Week 11th Legislative Update (Week Ending March 26, 2010)

Lawmakers Prepare to Adjourn
****This is only a summary of Legislative Action and a Congressional Update; upon adjournment an end of session bill status summary will be sent out*****
Idaho Legislature
During this 11th week of the 2010 Legislative Session, lawmakers accelerated their action on numerous pieces of legislation in anticipation of adjourning today. However, that seems unlikely now as a few bills have gotten caught up in re-writes and amendments. Adjournment may not take place until early next week.
Governor Otter has signed H391a into law, and Idaho Attorney General Lawrence Wasden has joined the lawsuit by 13 state attorneys general challenging the constitutionality of federal health care reform legislation. The Attorney General believes that there is a legitimate legal question which needs to be answered. The suit questions whether it is constitutional for Congress to require state residents to purchase health insurance. AG Wasden said the question involves issues of the Commerce Clause of the U.S. Constitution. As quoted in press articles, the Attorney General said “Our complaint alleges the new law infringes upon the constitutional rights of Idahoans and residents of the other states by mandating all citizens and legal residents have qualifying health care coverage or pay a tax penalty. The law exceeds the powers of the United States under Article I of the Constitution and violates the Tenth Amendment to the Constitution. Additionally, the tax penalty required under the law constitutes an unlawful direct tax in violation of Article I, sections 2 and 9 of the Constitution.”
Otter’s legal counsel, David Hensley, presented a new bill to committee. This measure is a non-binding joint memorial that would “call for a change to the U.S. Constitution to prevent Congress from passing laws requiring citizens of the United States to participate in any health care program, or penalizing them for declining health care coverage.”
The House Ways & Means Committee introduced a new version of the texting-while-driving bill that earlier passed the Senate and has been awaiting amendment in the House. The new version makes a first violation an infraction with a penalty of $50, and subsequent violations infractions with fines of $100. The new version also adjusts a definition to make clear that dialing a phone number doesn’t constitute texting.
Budget Bills
JFAC adopted a “contingency plan” to allow Gov. Butch Otter to tap reserve funds and building project funds if state revenues continue to slide after lawmakers adjourn for the year. The state still has a $23 million cushion between the $46.1 million in shortfalls that have occurred to date and the adjusted 2010 budget for this year. The budget was set on the estimate that revenues this year would fall 7.5 percent below last year’s level, but legislative budget director Cathy Holland-Smith noted that they’re now running 9.5 percent below. If that keeps up, the Governor would either have to find more money to balance this year’s budget by June 30, or call a special session of the Legislature.
H 701, the Medicaid budget, passed the House Wednesday on a 38-30. The Senate may vote on it this afternoon. The budget represents a decrease of $22 million in general funding and $90 million in federal funding for Medicaid services to poor children, pregnant women and the aged and disabled. This takes $100 million out of the state health care industry. The bill also has numerous sections of intent language, which among other things allows the department to delay provider payments until July 1, 2010, freezes increases in provider payments, directs the department to not pay more than Medicare rates for services from providers, and allows the Department to write temporary rules that change optional benefits for recipients of Medicaid.
The appropriation for the Millenium Fund, including another $500,000 for the Idaho Meth Project passed the Senate on a 29-3 vote.
House has voted 50-19 in favor of SB 1418, the public school budget bill, sending the Senate-passed measure to the governor’s desk. The bill, with historic cuts, spends half the state’s budget in a single piece of legislation. The budget proposes cuts in teacher and administrator salaries, and shifts money from line items into discretionary funds for school districts. That way, districts can decide where to make cuts at the local level.
JFAC has also adopted “intent language” for the Department of Administration budget that extends the waiting period for health coverage for new state employees from 30 days to 90 days.
The Senate has voted 26-9 in favor of SB 1419, the budget bill for state colleges and universities for next year. The budget reflects a 14.1 percent cut in state general funds and a 7.8 percent overall cut.
Congressional Health Care Reform
This week, Congress passed and the President signed into law health care reform legislation. Certain parts of the follow up fixes contained in the budget reconciliation bill were ruled out of order in the Senate, so these changes, which are considered minor, will have to be voted on by the House.
The 2200 page bill contains many provisions which will roll out over a period beginning this year and commence until full implementation in 2015. The bill contains sections which address nursing workforce shortages and loan repayment, nurse-run primary care clinics, and nursing education as well as other nursing practice and supply related implications. The bill includes administrative simplification for insurance billing, insurance reforms that address pre-existing conditions among other things, the creation on non-profit coops in states to facilitate the purchasing of affordable insurance and creates a federal subsidy for those who cannot afford to buy insurance. It expands Medicaid to 133% of poverty, increases reimbursement for physicians taking Medicaid and makes changes to Medicare Advantage plans. It includes delivery system reforms that encourage and incentivize the utilization of integrated health care systems such as demonstration projects on bundled payments, medical homes, clinical integration models, and accountable care organizations. It also creates demonstration projects that address medical liability reform. It expands frauds and abuse provisions and creates penalties for readmissions, and hospital acquired infections. It increases focus on wellness and prevention. It creates a Center for Innovation within CMS, and a National Workforce Commission. It addresses geographic variation.
As the final law is analyzed in detail and documents are produced by nursing and practice related organizations, they will be forwarded on to you.