Capitol Comments

Friday, a U.S. appeals court upheld a 2011 Florida law that prohibits doctors from discussing gun safety with their patients. The 2-1 ruling...

According to the Bureau of Labor Statistics, the unemployment rate for those with less than a high school diploma was11 percent in 2013 - nearly 4 percentage points higher than the national average and almost triple the unemployment rate for those with a bachelor's degree. 

Cigarette smuggling across state lines is a serious problem, costing states billions in lost revenue each year and creating challenges for law enforcement. 

US Education Secretary Arne Duncan called for states to develop methods to place effective teachers in high-poverty schools in a letter earlier this month. Calling for a plan to ensure equal access to qualified teachers regardless of race or income from each state by April 2015, Duncan also introduced the Educator Equity Support Network, which will work with states by compiling best practices and providing technical support related to implementation. Concurrently, the Education Department will provide each state with its data file from the Civil Rights Data Collection which will serve to highlight current income- and race-based gaps in access.

Punting the football… Kicking the can down the roadHitting the snooze buttonStill driving blind… Road to nowhere… Spinning wheelsRiding on four flat tires…  Pick your favorite metaphor and it’s probably been used to describe the House-approved temporary fix that the U.S. Senate appears poised to pass next week to rescue the dwindling federal Highway Trust Fund and ensure reimbursements for transportation projects will continue to go out to states through next May. It’s a plan that no one seems to like, that mostly prolongs the uncertainty states have faced in recent years with regards to the federal transportation program and that sets up another battle for next spring, albeit in what could be a substantially different looking new Congress. I also have a look this week at President Obama’s Build America Investment Initiative and a super-sized roundup of links from the last three weeks on reauthorization of MAP-21, the future of the Highway Trust Fund, state activity on transportation revenues, public-private partnerships and tolling and state multi-modal strategies.

Kentucky’s Senate Bill 7 will now allow nurse practitioners to prescribe medications on their own, after prescribing under a physician in a collaborative agreement for four years. Nurse practitioners in Kentucky will still need a collaborative agreement with a physician to prescribe narcotics. Senate Bill 7 was passed on February 26, 2014 and went into effect on July 15.

According to new research by the Urban Institute, yesterday’s court rulings on Obamacare subsidies could mean a big drop in federal funds flowing into some states. The Urban Institute says that 11.8 million individuals are expected to enroll in the 34 Federally Facilitated Marketplaces (FFMs) in 2016 and of those, 7.3 million are estimated to receive federal subsidies to purchase insurance. Some of the lowest income recipients will also receive additional subsidies to lower the cost of their co-payments, deductibles and co-insurance.

On July 22, 2014, two federal appeals courts handed down opposing rulings on the legality of tax credits to reduce the cost of health insurance premiums purchased in the 36 states with federally facilitated exchanges. In those states, 4.7 million individuals receive tax subsidies, averaging $264 per month, to make their premiums affordable. No changes are anticipated in the availability of tax subsidies during the appeal of these decisions. Pundits are betting that the ultimate stop for the cases will be the U.S. Supreme Court. 

In Harris v. Quinn the Supreme Court held 5-4 that the First Amendment prohibits the collection of an agency fee from home health care providers who do not wish to join or support a union. 

Medicaid recipients who would otherwise be institutionalized may hire personal assistants.  In Illinois, the Medicaid recipient is the employer and is responsible for almost all aspects of the employment relationship.  But the personal assistant is a state employee for collective bargaining purposes.  A number of personal assistants did not want to join the union or pay it dues. 

InfraAmericas logoAs states continue to experience infrastructure deficits and uncertainty about how those needs will be met going forward, public-private partnerships (P3s) have become an important tool in the toolbox for some when it comes to project finance and delivery. But the types of projects being pursued and the types of agreements states are entering into with the private sector have evolved considerably in recent years. Past experiences have made both states and private investors more discerning and deliberative partners. Federal tools such as the TIFIA loan guarantee program have helped many large P3 projects advance but doubts about the future of the federal transportation program overall have prompted some states to hesitate in pursuing many large, long-term projects.

Pages