By Bobby Harrison/NEMS Daily Journal
JACKSON – Surveying the landscape from high above, predicting future outcomes based on past actions, there does not seem to be an easy solution to the current Medicaid impasse facing the Legislature and Gov. Phil Bryant.
The 2013 legislative session came to an end last week. Legislators left town without funding or reauthorizing the Division of Medicaid for the new fiscal year, which begins July 1.
Everyone acknowledges legislators will have to come back in special session before July 1 to deal with Medicaid. The governor says he does not intend to call that special session until an agreement is reached.
Reaching that agreement may be easier said than done.
The issue centers around the option provided by the Patient Protection and Affordable Care Act for states to expand Medicaid to cover those earning up to 138 percent of the federal poverty level (about $15,000 annually for an individual) with the federal government picking up the bulk of the costs.
Democrats want to debate and vote on the issue in the Mississippi House.
Speaker Philip Gunn, R-Clinton, and Bryant say it ain’t going to happen because there is no need to put the House through contentious debate on something that will not occur.
As it stood when the session ended, the Democrats had the votes to block passage of bills to fund Medicaid and to reauthorize it, but did not have the votes to force a vote on expansion.
Something is going to have to change in special session – either the speaker or the Democrats – in order to reach agreement.
In short, Gunn and Bryant hold most of the good cards. Democrats are hoping their bluff is not called.
As it stands now, when Bryant calls a special session he will limit the agenda to funding Medicaid and reauthorizing the agency, but will not include the code section of law needed to take up expansion.
Now there is a legitimate school of thought that the governor does constitutionally control what topics can be discussed in special session, but he cannot limit how those topics are dealt with. In other words, if the governor calls a special session on Medicaid, and enough legislators want to consider expansion, the state’s chief executive officer cannot keep that from happening.
But in this particular case, Gunn, as presiding officer of the House, will simply rule the issue of Medicaid expansion is outside the call of the special session and that will be it.
I have seen presiding officers of both the Senate and the House rule liberally and conservatively in terms of what can be taken up in special session. Their rulings, it seems, often have been based on what gives them the best chance of accomplishing their desired outcome.
In the end, though, there is no way to get around the ruling of the presiding officer except by convincing a majority of the chamber to overturn that ruling. That has not happened in recent history, and it is not likely to occur anytime soon.
And no judge is going to get involved in a fight over the internal politics of the Legislature.
So, if the speaker says that Medicaid expansion is outside the agenda of the special session, and cannot be addressed, that would leave Democrats in the House few options.
Thus far Democrats have been remarkably cohesive on the issue of Medicaid expansion. If they remain cohesive in special session, they can again block the continuation of the existing program.
While the speaker is holding a strong hand, the Democrats can only hope the speaker and the governor do not call their bluff.
Are Democrats really willing to put in jeopardy an existing Medicaid program that provides health care for about 640,000 disabled, poor pregnant women, poor children and a certain segment of the elderly in order to try to get health care for about 300,000 people earning less than $15,000 annually – primarily the working poor?
It is kind of unusual twist. In the past, it has been primarily Democrats who have championed the existing Medicaid program while Republicans always have said they were fighting for the state’s workers.
Now the Republicans are trying to continue the existing Medicaid program, and it is the Democrats trying to add working people to the program.
The result is an impasse with no easy solution.
BOBBY HARRISON is the Daily Journal’s Capitol Bureau Chief. Contact him at email@example.com or call (601) 353-3119.