Tolbert: Senate President Says All Or Nothing On Medicaid Budget, Private Option (UPDATE)

Arkansas Senate President Pro Temp Michael Lamoureux is rather judicious with his tweets, but today he broke a bit of news on the upcoming debate to renew the private option.

As I have written in the past, the votes could be very close in the Senate with the change in the Senator from Jonesboro and the recent reversal of Sen. Missy Irvin with her position.  So the push is now for every vote, especially in the Senate where 9 Senators could effectively block the continued funding.

“All Medicaid funding will be voted on in one vote on one appropriation bill. There is not an opportunity to vote for some and against rest,” tweeted Lamoureux today.

What this seems to indicate is that the Republican Senate leader will push for one vote for all the funding without a separate opportunity for Senators who oppose the private option to vote against the private option funding but for the funding for the rest of Medicaid.

This also seems to contradict both assurances from Rep. John Burris in a House committee hearing last year as well as more recent statements from Sen. Jonathan Dismang who is one of the Senate point men on the private option.

“I have no interest in turning the DHS budget into an all or nothing political game. If the DHS appropriation cannot attain the needed votes with the private option included, then it will be pulled, amended, and voted separately,” said Dismang in a story I wrote in September.

Today, Dismang reiterated this telling me, “I will vote to remove language if passage isn’t possible.”

When I asked Lamoureux if this was inconsistent with what Dismang is saying, he said he is not sure but he “got (his) info from budget staff.”

This is an interesting development in what promises to be an interesting showdown in the upcoming fiscal session in February.

UPDATE – I spoke this evening with Lamoureux as well as with Joint Budget House Chair Duncan Baird and I think I have a bit more grasp on what the Pro Tem was saying.  Let me attempt to explain.

Lamoureux tells me that his statement is not inconsistent with what Sen. Dismang is saying.  His statement was to the budget process, not to any political strategy.  The appropriation bill that includes the funding for the private option will be contained within one line item for DHS for all federal funds directed to Medicaid.  That is the normal budgetary process.

Now where it gets tricky quickly (and was not what Lamoureux was speaking to) will be what happens if this budget fails to get either the 75% needed in either the House or the Senate.  I am not the House Parliamentarian so bear with me here.

Normally, when the budget chair sees that the 75% support is not there to pass the bill, he will pull it down and ask to send that appropriation back to Joint Budget Committee “without objection.”  However, my understanding is that at this point someone – likely a proponent of the private option – could object, thus forcing a vote on referring the bill back to committee (it’s unclear if this vote would need a simple majority or two-thirds).  The result here could be that the proponents could block the bill going back to committee forcing an all-or-nothing vote.  A game of chicken would ensue to see who blinks first (or neither could blink and the entire Medicaid budget would be defunded).

Once (or if) the bill did make it back to committee, it would require special language to be attached to the appropriation to direct DHS not to spend the appropriation on the private option.  It is unclear how this would be structured and could require a majority vote of both the full Joint Budget Committee and the JBC – Special Language subcommittee.  Now remember – the majority of the members of both of these committees support the private option, so enough of the supporters would have to vote – along with any opponents on these committees – against their desire to fund the private option by amending the bill to defund.  Sen. Dismang is Senate chair of JBC Special Language and he says he is open to doing this so that likely would help, but it would still take the will of a majority of these committees.

The long and the short is that if the original “normal” appropriation bill does not pass on its initial try in both chambers, it will get rather complicated quickly.  It appears that it is possible, in theory, to appropriate all federal funding in Medicaid except for the private option, but the process is bumpy to say the least.