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A Seat in the House

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A Seat in the House

Health care... or health insurance... reform bill raises concerns for Idaho

Health care reform legislation has been a primary effort of Congress over this past year. The House passed its version of health care reform in November and the Senate passed its legislative proposal on Christmas Eve day at 7 am. There are distinct differences in the two pieces of legislation and the Senate and House will need to meet together in committee to reach agreement on final legislation that can be presented to both bodies of Congress and then, if passed by both the Senate and House, forwarded to the President for his approval before health care reform becomes law.

In the hours before the Senate voted on its version of health care reform the Senate leadership negotiated a deal with Senator Ben Nelson of Nebraska on Medicaid funding requirements for his state and an insurance tax exemption for non-profit insurers in his state to obtain his support. 

Medicaid funding is provided by both state and federal funds and there is concern among many state legislators that provisions now contained in proposed health care reform will require more funding by the states. Senator Nelson’s agreement supposedly provides that the federal government will fund 100 percent of the cost for new Medicaid recipients for Nebraska residents. It was also reported by at least one news media organization that Senator Nelson also obtained agreement for an exemption from the insurance tax paid by non-profit insurers in Nebraska that is not applicable to other states except for Michigan. 

Several people have asked me if the agreement made between Senator Nelson and Senate Majority Leadership was legal and/or constitutional. In an attempt to answer the question I contacted both Idaho Senator Mike Crapo’s office and the Idaho Attorney General’s office for a legal opinion on the agreement.

Senator Crapo’s office did not have an opinion at this early date, but office staff stated that “there are several senators checking into this now to see if this (the agreement) goes against the constitution.”

The Attorney General’s office had already received several calls before mine questioning the legality or constitutionality of the agreement but had not developed an official opinion because the agreement would not be in force until health care reform legislation would become law.

I was informed, however, that if the agreement was implemented it could have a problem in that it might violate federal uniformity of tax laws requiring that one state not be taxed differently than another state. As stated in the beginning of this article, the Medicaid program is funded both by the federal government and individual states based on a federal funding formula. As I understand the information from the Attorney General’s office, Senator Nelson’s agreement would increase federal funding for Nebraska on a scale larger than provided by the formula, thus would be counter to uniform tax laws.

Many would say that this type of agreement is not unusual in negotiations involving passage of federal legislation; others feel that this particular agreement goes beyond appropriate negotiation and should not be supported.

It will be interesting to see if the agreement between Nebraska Senator Nelson and the Majority Party Leadership survives in the coming weeks ahead as Congress attempts to pass health care reform legislation. I anticipate that if a national health care reform law is passed and the agreement with Senator Nelson allowing special treatment for Nebraska is implemented that other states would challenge the agreement.

At about the time this issue of the River Journal hits the street the Idaho legislature will be close to convening the 2010 session.  The legislature convenes on January 11 and as we proceed through the session I welcome your input on issues that are important to you. You can contact me in Boise by e-mail at infocntr(at)lso.state.id.us  or by mail at State Capitol Building, P.O. Box 83720, Boise, Idaho 83720-003. I can also be reached toll-free at (800) 626-0471.

Thanks for reading! George

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Rep. George Eskridge Rep. George Eskridge the Republican Representative for District 1 in Idaho’s House, George Eskridge can be reached at 208-265-0123 or write PO Box 112, Dover, ID 83825

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