Breaking a budget logjam, Missouri lawmakers agreed Wednesday to continue funding a blind health care program that had been targeted for elimination, but they attached strings that could require some people to pay premiums and eliminate coverage for others with higher incomes.
Gov. Jay Nixon's office indicated it might ignore the new eligibility limits, asserting they were invalid because they did not change existing state law.
The blind benefits were among several issues resolved by a conference committee of House and Senate members, clearing the way for Missouri's $24 billion budget plan to potentially win final approval by Thursday - a day ahead of a constitutional deadline.
Among other things, lawmakers agreed Wednesday to create a new dedicated funding stream for veterans' nursing homes and to boost state aid for several universities. Negotiators decided not to include contentious wording in the budget that would have barred state money from supporting the Sue Shear Institute for Women in Public Life, a nonpartisan organization at the University of Missouri-St. Louis that some Republican lawmakers contend has churned out Democratic trainees.
All of those issues were intertwined earlier this week as debate ground to a halt in the Senate and the fate of the budget appeared less certain.
Assuming revenue projections pan out, the budget plan forged Wednesday should leave a positive balance of $2 million or $3 million, said Senate Appropriations Committee Chairman Kurt Schaefer.
"It's definitely balanced," said Schaefer, R-Columbia.
But it's a precarious balance, and a smaller one than normal. The budget assumes the Missouri Lottery will generate an additional $35 million for public K-12 schools during the fiscal year that starts July 1. But it is not clear how the lottery will come up with that much money. Some lawmakers have suggested if the lottery pays out a greater percentage in prizes, ticket sales will rise and so too will the amount available for education.
The increased lottery proceeds are necessary to fill a gap created by a complicated money shuffle stemming from a decision to earmark the majority of the state's casino fees to veterans' nursing homes. After senators passed the veterans funding bill Wednesday, negotiators from the two chambers quickly resolved the rest of their lingering differences on the budget.
Their plan will provide $25 million in cash to a decades-old program that provides health care coverage to more than 2,800 blind residents who earn too much to qualify for traditional Medicaid but who have no more than $20,000 in assets besides their homes. The House version of the budget originally had proposed to scrap the program and replace it with a significantly slimmed down benefit plan.
The conference committee agreement would provide about $3 million below full funding for the program. The gap would be made up by limiting participation to those earning up to three times the federal poverty level - about $33,500 annually for an individual - and charging premiums to those earning more than 150 percent of the poverty level. The premiums would follow a structure that already exists for a children's health insurance program, resulting in payments ranging from $13 to $102 monthly, according to the Senate Appropriations Committee staff.
Nixon spokesman Sam Murphey said the governor was pleased with the funding "for this vital lifeline for blind Missourians."
"But the attempt to place additional limitations on eligibility through the budget process does not change existing law - and is invalid," Murphey said in an email. "We will ensure that this program continues to serve all 2,800 needy, blind Missourians who depend on it."
Earlier this week, blind residents had walked with white canes and service dogs up the Capitol steps to call upon lawmakers to fund the program.
Denny Huff, president of the Missouri Council of the Blind, said Wednesday he was satisfied with the compromise.
"It's the ones that are really hurting - the ones that are on a very low income that have tremendous prescription costs - those are the ones we were concerned about," Huff said.
House Budget Committee Chairman Ryan Silvey said "it was never anyone's intention to be mean-spirited" by proposing to end the program. But he reasserted his belief that the blind were getting special health care coverage not available to the deaf or quadriplegics.
"It's not that we are singling them out because of their disability," said Silvey, R-Kansas City. "We're singling them out because of the different treatment they have received over the decades."
Also Wednesday, budget negotiators agreed to provide an additional $3 million, split among seven universities, to address perceptions that some institutions have been underfunded on a per-pupil basis. The funding hike was an alternative to a $2 million increase that House Speaker Steven Tilley had sought for his alma mater of Southeast Missouri State University, which has the second lowest funding on a per pupil basis.
Earlier this week, budget negotiators also agreed to provide a 2 percent pay raise to state employees earning up to $70,000 annually.