Senate Majority Leader Reed Addresses Medicaid, Autism Funding, Redistricting

Senate Majority Leader Greg Reed today said the Legislature still has the two budgets to pass and will pack in its meeting days over the next three weeks in order to meet the session’s May 22 ending deadline.

“We’ll likely see the General Fund in the Senate this week,” Sen. Reed, R-Jasper, said, adding that the House and Senate will meet three days this week for the 22nd, 23rd, and 24th legislative days of the session that cannot last beyond 30 working days.

That would leave six legislative days for the next two weeks and one day, Monday, May 22. “But we don’t have to meet 30 days,” Sen. Reed told the Business Council of Alabama’s Tuesday briefing that was sponsored by the Drummond Co. Inc.

The $1.84 billion General Fund budget bill, HB 155 by Rep. Steve Clouse, R-Ozark, is in the Senate Finance and Taxation General Fund Committee, and the $6.4 billion, 2017-18 Education Trust Fund budget bill, SB 129 by Sen. Arthur Orr, R-Decatur, awaits action on the House calendar.

HB 284, the autism coverage mandate bill by Rep. Jim Patterson, R-Meridianville, is in the Senate Finance and Taxation General Fund Committee.

The bill mandates what amounts to a health insurance tax that BlueCross-Blue Shield of Alabama estimates would cost policyholders and large and small businesses that provide medical insurance between $49 and $98 million annually, the Associated Press reported today.

The Business Council of Alabama, writing about a compromise piece of legislation, HB 404 by Rep. Jack D. Williams, R-Vestavia, is concerned about the cost of the mandate to business and individuals and taxpayers.

The House passed Rep. Patterson’s HB 284 without knowing the cost of providing autism spectrum therapies to taxpayers who fund Medicaid, to private businesses and employees, and public employees who pay for private insurance coverage.

“There are challenges for that legislation,” said Reed, deputy chairman of the Senate Health and Human Services Committee that rides herd over Medicaid issues.

“This is an issue important to the people of Alabama and important certainly to those families (of autistic children) but it’s also important to industry because the treatment of these conditions for these children can be extraordinarily expensive,” Reed said.

“When you think about that, we as legislators have to manage not only the public benefit and the public health but also the business climate and the opportunity that promotes an appropriate business schedule so that we’re not mandating what business has to do,” Sen. Reed said.

Sen. Reed said an amendment added in the House that would mandate Medicaid coverage for autism therapies does not have a Legislative Fiscal Office cost estimate but that is being worked on. “I’m told that number could be as high as $20 million,” Sen. Reed said.

If so, $20 million would be a 3 percent increase to the General Fund portion of Medicaid’s current $701 million proposed appropriation. The bill assumes passage of a proposed tax increase to pay for current programs.

Sen. Reed, the force behind a Medicaid revision over the last several years with the creation of Regional Care Organizations and integrated care, said the General Fund is strapped for cash now. Legislators are trying to rein in Medicaid cost increases that are pushing $100 million a year.

“My goodness, we don’t have enough money to fund our Medicaid program as it is,” Sen. Reed said. “We have to have additional resources for the RCO model. Add $20 million on the top of that would be a struggle.”

Sen. Reed said it’s unknown whether the House and Senate will be able to accomplish legislative redistricting as ordered by a federal court before the session ends on or before May 22.

Bills have been introduced in the House and Senate to redraw districts that can pass court muster. The House bill came out of committee today.

“If you leave out politics we can do it,” Sen. Reed said.