Obamacare Exchange Money Stripped From Appropriation Bill

“Here today, gone tomorrow” may have occurred to observers watching $9.8 million for a state Obamacare “exchange” appear and then disappear from a (mostly) noncontroversial supplemental appropriation bill bouncing between the Michigan House and Senate last week.

The final bill, now on its way to Gov. Rick Snyder for an expected signature, does not include authority to spend this money, which as CapCon reported earlier, was awarded by the federal government on Nov. 29, after the state applied for a “Level 1 Establishment Grant” under the federal Patient Protection and Affordable Care Act. Under the Michigan Constitution, no money can be spent by the state — including federal grant money — unless the Legislature passes an appropriation bill authorizing the spending.

The context for the back-and-forth was established in November, when the Senate passed a bill to create a state Obamacare exchange. (For background, see “Senators Admit Obamacare Is Unconstitutional,” CapCon, Nov. 16.)  (Who Voted "Yes" and Who Voted "No")

House Republicans have shown no eagerness to follow, and that reluctance extended to this appropriation bill. In the colorful words of House Appropriations Chair Chuck Moss, R-Birmingham, to MIRS News, "They'd rather be caught sacrificing to Satan than voting for Obamacare, so that's the way it is."

Here is an edited recap of the House/Senate “ping-pong” match on the appropriation bill, as described by MichiganVotes.org:

• Passed 103 to 5 in the House on Oct. 19, 2011, to appropriate an extra $320.4 million for two items. The first is $119 million that is nearly all federal money to provide incentive payments to health care providers to adopt state-approved electronic health care record systems. The second appropriates the money from a new 1 percent tax on health insurance claims designed to “game” the federal Medicaid system to get higher federal payments to Michigan’s medical welfare system (which replaced an earlier tax on providers).
  (Who Voted "Yes" and Who Voted "No")
• Passed 28 to 8 in the Senate on Nov. 10, 2011, to enact a version of the bill with some new spending items added, including $9.8 million to create a state "Obamacare exchange." Total spending rose to $366.3 million. (Who Voted "Yes" and Who Voted "No")
• Passed 101 to 7 in the House on Dec. 13, 2011, to reject additional spending added by the Senate, including the “Obamacare” money. Total spending back down to $351.7 million. (Who Voted "Yes" and Who Voted "No")
• Passed 20 to 17 in the Senate on Dec. 14, 2011, to concur with the House, and not authorize spending $9.8 million for a state “Obamacare exchange.” (Who Voted "Yes" and Who Voted "No")

Finally, “noncontroversial” is a relative term. Advocates of specific government spending items that were not included in the final bill will view those deletions as very controversial. Many doctors and other medical service providers view the pressure to adopt government-approved electronic health care record systems as highly intrusive and burdensome, notwithstanding possible taxpayer subsidies. Welfare-state opponents view new state taxes imposed for the sole purpose of extracting more Medicaid money from federal taxpayers as proof that the system is dysfunctional, if not corrupt.