Thursday, June 27, 2013

State House News:

Governor Nikki Haley released her vetoes of the State Budget on Tuesday.  The House took them up yesterday and, of the 81 vetoes totaling about $100 million, the House sustained 28.  This means that the 53 vetoes overridden by the House will be taken up by the Senate today, which will also require a 2/3 vote to override.
Among the vetoes overridden by the House impacting health care were $1.5 million in funding for breast and colon cancer screenings.  However, most of the controversy yesterday surrounded the health care vetoes that the House sustained, namely Haley’s veto of funding for the certificate of need (CON) program and of an alternate Medicaid expansion.
As in years past, Haley has expressed her dislike for CON with her veto pen, once again defunding the CON program operated by DHEC.  Unlike in years past, the House sustained the veto, a surprise to many in the health community.  No one is exactly sure what the defunding of the CON program means, for there is speculation that DHEC can shift funds from other sources to continue the program.  Early response from DHEC, though, signals an intent to follow the Governor’s wishes.  This means that there is a possibility that no health care projects requiring CON will be able to move forward next year.  DHEC would have no staffing to consider and approve CON requests, and the reality is that the law of South Carolina requires CON in many instances of expansion or new equipment purchases.   So if a health care project can’t get a CON, it will have to sit dormant next year.
Another controversial veto was of a proviso in Medicaid’s budget that required Director Keck to apply for a waiver to expand Medicaid if CMS decides to allow states to expand their programs to childless, non-disabled adults up to 100% of the federal poverty level (FPL).  Although the federal government has not allowed for this waiver, and likely won’t, this would have been a backdoor into bringing the bulk of the Medicaid expansion to South Carolina.  Haley made her veto about opposing Obamacare, and the House agreed, sustaining her veto.
The Senate will not be able to consider the CON or Medicaid vetoes since the House already sustained them.  The SCMA will keep you apprised of developments to the CON issue.