Ethics panel: 6 can vote on Medicaid

By Bobby Harrison/NEMS Daily Journal

JACKSON – The Mississippi Ethics Commission reversed previous rulings Friday and said legislators who work for health care providers that treat Medicaid patients can vote on Medicaid issues.
The commission also said that legislators with family members who receive Medicaid reimbursements may vote.
The rulings were sought by Speaker Philip Gunn, R-Clinton, after six Republican House members did not vote during the 2013 session on funding and reauthorizing the Division of Medicaid for the new fiscal year, which starts July 1. The change could have an impact on legislative deliberations in an expected upcoming special session.
House Democrats, demanding the speaker allow a vote on expanding Medicaid as is allowed under federal law, were able to block funding and reauthorizing of the existing program in part because the six Republicans did not vote.
Presumably, armed with Friday’s Ethics Commission decision, Gov. Phil Bryant, an ardent opponent of expansion, will call a special session in the coming weeks to try to reauthorize and fund the existing program that provides coverage to about 640,000 disabled, elderly, poor pregnant women and poor children. The expansion would add an estimated 300,000 to the rolls, primarily the working poor.
Friday’s Ethics Commission decision was 5-3, the minimum number of votes for the commission to enact a ruling. The opinions provide public officials legal protection if they adhere to them.
If no votes change from the regular session and the Republican members impacted by Friday’s ruling vote with the majority of their party, there will be enough votes to fund Medicaid, but not to reauthorize it. The reauthorization requires a three-fifths majority because it includes taxes on hospitals and nursing homes.
The Ethics Commission has made numerous rulings through the years on Medicaid-related questions.
But in the most recent December decision, the commission reaffirmed that a legislator employed by a Medicaid provider “must recuse himself or herself from any measure which will result in a pecuniary benefit for his or her employer.”
On Friday, the commission ruled that while in some instances a legislator who works in the health care industry should not vote on a particular Medicaid issue where there is a direct impact, in general the members could vote on reauthorization and appropriation. The ruling was based in part on the fact that other entities, including federal agencies, affect the amount of money going to health care providers.
Commission member Bill Wheeler of Tupelo said he could not understand the majority’s decision since it still took legislative action for those health care providers to receive Medicaid funds.
Ethics Commission Executive Director Tom Hood said the reversal by the commission was made in part because of past court rulings. The courts have ruled that legislators whose spouses are school teachers could vote on education appropriations. He said legislators who work in the health care field were being held to a different standard by past Ethics Commission rulings.
“This is a difficult situation for all of us,” said Commission member Paul Breazeale of Jackson, who was part of the majority in Friday’s ruling. “We do have opinions that differ in the past. It is a very timely issue.”
The Ethics Commission took the additional step of opining that the legislators could vote no Medicaid expansion, but “advises … the requester to recuse himself or herself from any measure which would expand the Medicaid program.”
While the House speaker asked for “a blanket” opinion, the Ethics Commission required each individually impacted House member to make a separate request. By law, the names of the public official requesting an opinion of the Ethics Commission are not made public, though it is known that Reps. Donnie Bell, R-Fulton; Lester “Bubba” Carpenter, R-Burnsville, Margaret Ellis Rogers, R-New Albany; Mac Huddleston, R-Pontotoc, were among the six requesting the opinions.
The commission did not rule on one of the individual requests because of a lack of information, but the general ruling would appear to cover all the members.
Rep. Bobby Moak of Bogue Chitto, the minority Democratic leader, said each individual member still should be guided by his conscience on whether there is a conflict and that the Ethics Commission opinions should be part of that decision process, but not the overriding factor.
Moak said he also was disappointed that the House leadership was “going to the extreme” of petitioning the Ethics Commission to make a ruling for “a certain vote.”
Commission member Billy Powell of Madison, who was one of three Republican Party leaders Gunn dined with after hours in his Capitol office after the session ended, said the speaker had not spoken to him about the Medicaid issue.

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