SECOND REGULAR SESSION

House Concurrent Resolution No. 19

93RD GENERAL ASSEMBLY

4907L.03I

      Whereas, it is the state's right to control spending its own tax dollars; and

            Whereas, the Congressional Budget Office (CBO) estimates the additional cost to states created by the Medicare Modernization Act of 2003 will total $124 billion from 2006 to 2015; and

            Whereas, these additional costs will result from the Medicare Modernization Act reimbursement mechanism, popularly known as the "clawback provision", by which states are required to repay the federal government for dual-eligible enrollees who qualify for both Medicaid and Medicare; and

            Whereas, our state dual-eligible program costs have been efficiently managed in the past two years with the implementation of cost-saving measures that include negotiated rebates and a pharmacy providers' tax; and

            Whereas, the extra cost to the state of Missouri resulting from the "clawback provision" is estimated at approximately $90 million in the first twelve months of the program; and

            Whereas, our state is in a budgetary crisis and significant moneys have been taken from health care to balance last year's budget; and

            Whereas, these moneys need to be redirected to improve the health of Missourians; and

            Whereas, some members of Congress have attempted to respond to this controversial provision of the Medicare Modernization Act of 2003 with legislation introduced to delay or improve the implementation of the prescription drug portion of the Act; and

            Whereas, at least nineteen other states are arguing that the "clawback provision" operates as an unconstitutional tax on state treasuries; and

            Whereas, a number of these nineteen states have announced their intent, either individually or collectively, to actively pursue a challenge to the constitutionality of the "clawback provision"; and

            Whereas, the legal challenges to the "clawback provision" are not limited to the argument that the provision operates as an unconstitutional tax upon the states. The legal arguments include claims that the provision is an unconstitutional assumption of a state's sovereign function to raise revenue for a federal program and that the provision is an unconstitutionally coercive exercise of Congress' spending authority:

            Now, therefore, be it resolved that the members of the House of Representatives of the Ninety-third General Assembly, Second Regular Session, the Senate concurring therein, hereby support the Attorney General's intent to file a constitutional complaint regarding the clawback provision; and

            Be it further resolved that the Missouri General Assembly make reasonable restorations to Medicaid recipients, particularly Missouri Assistance for Working Disabled (MAWD), Missouri Assistance to Families, the elderly, and disabled, and to make a total restoration of the funding for optional services, such as dental, optometric, and durable medical equipment; and

            Be it further resolved that the Missouri General Assembly calls on its Congressional delegation to revisit the funding mechanism for the Medicare Modernization Act of 2003 to allow adversely affected states to opt out of the "clawback provision" requirement, based on individual state circumstances that may include budget constraints, state pharmaceutical cost-saving measures and state excludable costs; and

            Be it further resolved that the Chief Clerk of the Missouri House of Representatives be instructed to prepare properly inscribed copies of this resolution for Governor Matt Blunt and each member of the Missouri Congressional delegation.