Attorney Heffner Testifies Before House Finance Committee on Governor’s Medicaid Budget
On March 15th, I testified before the Finance Committee of Rhode Island House of Representative on the Governor’s proposed 2018-2019 budget. I specifically wished to alert the members of the Finance Committee to provisions contained in Articles 13 and 14 of the proposed which would enable the Rhode Island Office of Health and Human Services (OHHS) to promulgate regulations directly affecting eligibility for long-term care Medicaid benefits.
As I reminded the members, the General Assembly when it enacted the “Global Waiver” in 2009, specifically retained for itself through the legislative process the ability to change rules affecting eligibility. This was wise. For however imperfect the legislative process may be, it light-years more transparent to the people of Rhode Island than the “rule making process” of OHHS or any other state agency.
The House Finance Committee hearing that evening was a perfect example of the contrast between the two processes. Chairman Abney began the hearing by welcoming the many members of the public who had come to testify. He and other members of the Committee listened patiently and respectfully to all testimony, with members occasionally raising questions of the witnesses to gain further insight.
Having the privilege of serving as member of the House of Representatives for ten years, I am familiar with this process. Based on the testimony that evening-which lasted for nearly two hours—members of the Committee will reflect on what they heard, consult with the exceptionally able and professional staff of the Finance Committee regarding details of the budget articles, and confer with their colleagues. Most importantly, the members will able to continue to hear directly from the people they are privileged to represent regarding how any proposed changes in eligibility would affect them.
If instead the General Assembly gives up this prerogative to OHHS, the process will be dramatically different. There will be a public announcement by OHHS of the proposed promulgation of new eligibility rules. “Interested parties”—including members of the public will be able to come to a hearing and submit written or oral testimony to whomever at OHHS is given authority to make this eligibility changes.
However, unlike the potential for interaction with members of the Finance Committee, there will be no response from the OHHS officials presiding at such a “hearing”. And in contrast to the legislative process, that will be the first and last time members of the public will have an opportunity to have any input. Plus, there will be no way to ascertain whether that public input made any difference in the making of the rule. Rather, the end result will be pronouncement of a rule by an unelected “policy” bureaucrat at OHHS.
The General Assembly wisely retained the responsibility for making rules regarding Medicaid eligibility. OHHS is still trying to dig out from the damage done by this Administration’s “original sin” in September, 2016 of rolling out an new computer system to process Medicaid eligibility while simultaneously terminating experienced and dedicated caseworkers and supervisors with collectively hundreds of man and woman hours of actually helping applicants. Yet this Administration in Articles 13 and 14 of its proposed budget somehow thinks it a good idea to add to an already burdened OHHS more responsibility.
I was grateful for the opportunity in my testimony to provide this context to the members of the Committee. And I am confident that they will not throw away the prerogative retained by a previous General Assembly to make rules regarding the Medicaid eligibility on which many of their constituents depend.