This week the Senate passed Senator Buttrey’s SB405, Medicaid expansion, after it was blasted to the floor from the Finance and Claims committee before it could be voted on last Friday. Why? The bill would have missed transmittal to the house and been D.O.A. Lucky for Buttrey his oversight was saved by moderate Republican friends and Democrats in the Senate; the same friends who supported SB289 in stealing a part of your first amendment. The bill was then heard and subsequently passed, accepting zero amendments. Buttrey himself stated there were amendments but they would be stuffed into HB2 due to cost. AKA hiding the fiscal impact in a much larger budget bill. His idea of transparency wouldn’t past muster in even Clinton’s administration.

SB405 expands Medicaid to just over half of the Governors’ 70K people for roughly the same cost. So what gives? Who knows, devils in the details. The bill pays for work force development that takes from TANF funding and gives coverage to able bodied adults in an attempt to train them to work. This training is optional. Buttrey care has those on the plan paying a monthly premium and if they miss a payment it’s taken from their tax return. At $16,000 per year or less you will have a hard time making premiums, let alone get a tax return and be penalized for not paying — this means those premiums won’t ever be collected. Buttrey calls this “Skin in the game,” which Republicans generally would be happy to support. Buttrycare’s provisions, however, are impossible to enforce and thus meaningless . By the end of 5 years it is projected this bill will cover just over 40k people with the Feds picking up 90% of the tab, down from 100% the first year. What happens if Federal funds dry up? The premium payer pays more, which they can’t afford, or the taxpayers pick up the tab. We all know that no politician will take away an entitlement. All of this doesn’t even mention that hospitals are still only getting 40 cents on the dollar, yet clambering to support SB405. It is inevitable that in future sessions hospitals and Democrats will come back asking for the other 60 cents. “When you’re starving, half a loaf of bread is better than none” said one hospital executive during the Governors bill hearing.

The bottom line is Buttrey Care is a farce, an extension of Obama Care as defined in the Federal bill, and required for full implementation of the Federal Act. SB405 gives moderates cover as being able to compromise, the Governor what he wants in the bill, and Democrats a win in 2016 or Buttrey et all. What’s the difference really?