Crossover began on Friday, March 1. A much needed recess to help rest, heal and regroup before launching in to the 2nd half of the 2013 Legislative Session. Altogether, the House ran through 511 Bills and Resolutions. Of these, 133 failed, 10 were withdrawn and 18 Resolutions still remain to be decided. The last two weeks found few actual policy hearings held as that portion of the session drew to a close, Appropriations Committees found themselves thrust into overdrive and overtime, and the House Floor moved into long and often intense floor debates. All together, the last two weeks alone found us discussing nearly 200 bills on the House Floor.
Kudos to both Rick and Phil for keeping up with their reports during this time! I tried! – but found the need to study and be informed prior to each days floor sessions became paramount and all consuming as we faced a plethora of really important bills left to the last few days and weeks. So, in these past couple days I’ve been pondering just what I should write on. So much has already been reported on by TV, newspapers and radio… what’s remains to be said? Lets go with a recap of the hot topics that made my radar – and why I’ve voted the way I have. After all, voting is a matter of public record, but the why doesn’t always make it to the front.
Medicaid Expansion. HB 1362 was heard on the floor this past week and was a very heated debate. Rick and I were both able to sit in on this bill from the beginning as the original hearing was held jointly between the Policy and Appropriations Committees of the Human Services. In that first hearing, bill sponsor Rep. Al Carlson made the rather unconventional approach of presenting the bill in opposition, speaking to the need to consider all prospects, possibilities and affects of an expansion of Medicaid. He went on to explain his contention that North Dakota is in a much better position than most to create its own version of affordable health care for its citizens. Further testimony in that hearing was either in support of the expansion, or neutral to provide information for the financial comparisons between a Federal Medicaid Expansion and that of a State Program.
Several weeks later, in House Policy Committee, the discussion was long as we poured over the dollars – and the “sense” – of both prospects. Dollar for dollar, the expansion quickly began to make more sense since the federal government will pay for 100% of the program costs in the first three years, with a step down to a 90% buy-in by the year 2020. Rough estimates consider that between 15,000 and 30,000 North Dakota people will become eligible for Medicaid which would allow for up to 138% of poverty (current state regulations are at 133% of poverty). Based on these numbers, general fund dollars predict as much as $9 million in state dollars could eventually go into the program once the step down begins in 2017, but this compares to a very rough estimate of $34 million annual dollars for a state run program. Ultimately two key amendments came out of the committee work:
1. Language that protects North Dakota’s participation in the program to that of the Federal Government’s participation. The idea being, that if the federal contribution to the program decreases, leaving ND with a larger than anticipated portion of the pie, the state may then opt out of the program. The language requires the Department of Human Services to make this known to new enrollees so they understand the program is not an entitlement and may be reduced or eliminated dependent upon federal participation. Additional language requires the department to implement the expansion by bidding through private carriers – or the health insurance exchange – whichever proves best.
2. The second amendment enacts a study over the course of the next two years and sets an expiration date for the current legislation. Since so much of the expansion is based on speculative numbers, it only makes sense to analyze and use actual numbers based on what takes place in the next biennium to determine what is best going forward with the expansion as is – or if there might be a hybrid program that is a better for for the overall needs of North Dakota. Either way, the 2015 Legislation will have the benefit of these numbers and statistics to make determinations that make sense at that time.
The committee amendments were pulled and debated at length this past Wednesday. To be sure, it was long and at times intense, but was all very good debate. There was a conscious decision on behalf of both parties to NOT turn this policy debate into a political debate – that the concern is what is best for North Dakota. I was very proud of my Human Services Committee Chairperson and several others who valiantly defended to uphold the recommendations… of particular interest when considering their adamant and admitted opposition to the expansion in the beginning of the process. In the end HB 1362 succeeded with 57 yea – 36 nay. As one of those 57 yeas, it was a great relief to see the bill passed and moved forward – seeing this as the best first step in falling in line with new federal laws and the best interests of so many of our North Dakota residents.
Next week we’ll take up a couple more of the more high profile bills before moving into the Senate bills about to roll in. If there are any of particular interest that you’d like to hear about, please let me know. Till then, stay safe and warm as our March weather continues to march on!
Rep. Gail Mooney
701-436-5010 • firstname.lastname@example.org