UPDATE (7/9/2012 – 10:48 a.m.): Gov. Perry announced this morning that his administration will oppose Texas participation in the Medicaid expansion provision of the Affordable Care Act, as well as the creation of a state health insurance exchange. From the Perry statement: “"Neither a 'state' exchange nor the expansion of Medicaid under this program would result in better 'patient protection' or in more 'affordable care.' They would only make Texas a mere appendage of the federal government when it comes to health care."

AUSTIN, Texas - Stunned by the Supreme Court's recent decision to uphold President Obama's health-care overhaul, conservatives found some comfort in one part of the ruling. The Court rejected a provision that would have forced states to expand their Medicaid rolls with the help of federal dollars. The money will still be available, but optional.

Political scientists have described it as a states'-rights victory. However, lawmakers in Texas and other red states may be doing just as much squirming as celebrating, according to University of Texas-Austin government professor Bruce Buchanan.

"If they're having second thoughts, it's understandable, because it is an extremely advantageous package that the federal government is offering the states, with three years of 100-percent coverage."

Texas would leave big bucks on the table if it rejects the Medicaid expansion - probably more than $150 billion over the first decade. Starting in 2017, the state would be responsible for up to 10 percent of the new costs. Critics say that's 10 percent too much. However, rejecting the expansion would leave 1.5 million low-income Texans meant to benefit from the provision with no health coverage.

Buchanan, whose specialty is American politics, predicts that sooner or later most conservative governors and legislatures will set politics aside and choose to fully participate in the Affordable Care Act.

"They're still smarting from a completely unexpected Supreme Court decision. It's going to take a little time. Folks will have to go through the grieving process before they can come to terms with what makes the most sense for their states."

He says a just-released government report card ranking Texas worst in the nation in health-care quality makes it that much harder for politicians to justify turning down the Medicaid funds. The state also has the highest rate of uninsured residents, with 6.5 million people lacking coverage.

While decrying "Obamacare" as fiscally unsustainable, Gov. Perry and fellow Republicans have stopped short of declaring they will fight the Medicaid expansion. A Perry spokesman says Texas will not "fast track" participation. Buchanan thinks, ultimately, practicality will trump popular red-state political philosophies.

"There's resentment at federal control: If you take federal money, you have to cleave to federal guidelines. Texas is famous for having resented those kinds of things, which is partly rooted in the ideology of states' rights."

The legislature may take up the Medicaid expansion issue in January. Meanwhile, Texas leaders face another predicament: whether to set up the state's new insurance exchange or refuse to participate - thereby handing control to the feds.




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Missouri's House of Representatives approved a budget of about $51 billion just before a Friday 6 p.m. deadline.

Gov. Mike Parsons has labeled it the "largest supplemental budget in Missouri's history," and can either accept it as-is or make cuts.

Rep. Cody Smith, R-Carthage, the House budget chair, expressed satisfaction for managing to boost funding for education and infrastructure without risking budget shortfalls. He mentioned a surplus of more than $1.5 billion in general revenue, to be used for potential growth or future projects.

"We've got a balanced budget, we've got less spending than we did have last year, and we've got a healthy rainy day fund," Smith outlined. "I think that package is what I'm most proud of."

Smith is especially pleased with the infrastructure spending for Interstate 44 repairs but expressed disappointment in the budgeting process, due to the lack of a conference committee and challenges in the final weeks. Still, he described the final budget as "strong."

Sen. John Rizzo, D-Independence, the Senate Minority Leader, told reporters a special session could be needed due to the budget being "rushed" and the possibility of other issues coming up.

Rep. Crystal Quade, D-Springfield, the House Minority Leader, also shared her dissatisfaction with the budgeting process.

"We cannot allow the 'new normal' for spending taxpayer money to become just two guys writing a budget in secret and then jamming it through the process at the very last minute, full of pork and appeasing lobbyists," Quade stressed.

Quade described the budget as being completed in the "technical sense" but feels lawmakers deliberately low-balled spending, as several are competing in Republican primaries for statewide offices. She pointed out it is a strategy allowing them to claim credit for cutting overall state spending.


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Child care advocates are pushing for increased funding as the budget deadline approaches this Friday.

Robyn Schelp, director of policy and advocacy for Kids Win Missouri, said ensuring increases to child care subsidies remain in the budget are vital for every Missourian whether they have children or not.

"It impacts the entire workforce," Schelp pointed out. "We have to stop thinking that this is a parent's issue. It isn't. If we want teachers in the classroom and doctors at their offices and whatnot, we have to make sure there's childcare for their kids."

The legislature adjourned after just about 10 minutes on Monday, following a record 41-hour filibuster which went to 4 a.m. Thursday without agreeing on a budget. Missouri lawmakers have only missed the budget deadline one time, in 1977.

Sen. Cindy O'Laughlin, R-Shelbina, the Senate Majority Leader said on social media Friday the Missouri Freedom Caucus only yielded the floor under the threat of a motion to end debate. She tried to introduce the Federal Reimbursement Allowance, which she said is crucial for funding to offset general revenue and vital for Medicaid services.

The budget includes child care subsidies under House Bill 2002. Schelp noted the House's proposal would support only 23,000 children, restricting expansion and compliance with federal guidelines.

"Our hope is that it stays with the governor's recommendation, of that $52 million," Schelp emphasized. "Allowing them to go to that 100th percentile of payment for infants and toddlers and then the 65th percentile for preschool and afterschool."

Sen. Bill Eigel, R-Weldon Spring, is leading an effort to convince fellow members of his party to approve abortion restriction legislation and a bill on ballot initiatives in Missouri before agreeing to a vote on the reimbursement allowance.

A plan to use public money to fund vouchers for students to attend private schools is drawing pushback from Louisiana teachers, who say the plan could devastate the public school system.

The program making its way through the Louisiana Legislature would be first available to low-income students and by the 2027-2028 school year, it would be available to all students.

Larry Carter, president of the Louisiana Federation of Teachers, predicts the plan could cause significant budget cuts for public schools.

"These universal voucher bills are a step in the wrong direction," Carter argued. "We've seen in other states around the country, like Arizona and Ohio, where these bills have been passed, they're now facing a budget crisis, and we're hoping that we cannot go down that same road."

Carter pointed out the education savings account program known by the acronym LA GATOR would allow as much as $7,500 per student from families below 250% of the Federal Poverty Line, and $5,000 for those who make more.

The plan, House Bill 745 and companion Senate Bill 313, has been approved by the state House. The Senate is expected to vote on it by Friday or Monday.

Carter explained teachers are concerned classroom standards currently mandated for public schools would not be upheld in private or parochial schools.

"We want to make sure it has some accountability," Carter emphasized. "We think that's at least giving all education stakeholders and parents an opportunity to talk about whether this program is successful or not. And through accountability practices, we think that will help."

There is concern the plan would force public schools to eliminate many positions and needed programs. Carter fears the loss of funds could deprive students of the benefits of a public school education.

"If we're cutting that funding stream, Louisiana students will have fewer nurses and counselors, less options for after school program, and certainly limited access to field trips and AP courses that help prepare them for their next step in life," Carter outlined.