Issues in Legislative Council were far from settled
Published 12:00 am Thursday, June 24, 2004
It was the morning after the last day of the 2004 Regular Legislative Session. We were still tired and on edge from a long hard session. The meeting was supposed to be “short and sweet.” It was not short for we were still going nearly two hours later. It was not sweet for issues were bitterly contested. It was the longest and most intense Legislative Council meeting I have ever attended.
The Legislative Council is a governmental body created by act of the Alabama Legislature to handle certain issues that might otherwise require legislative action. Among its duties is the review and action upon proposed rules and regulations adopted by state agencies prior to their becoming effective.
This “short and sweet meeting” would consider two such rule changes. I was told that both had been worked out by all interested parties. The first issue was a proposed rule change dealing with drivers’ licenses. The second dealt with Medicaid prescriptions. As it turned out, neither issue was really worked out.
The first rule change would make it easier for citizens of foreign countries to obtain drivers’ licenses in Alabama. Since 9/11, it had become ever more difficult. This situation was affecting employees of current industries such as Hyundai, Honda, Mercedes and Toyota. It was also adversely affecting efforts to recruit new industries.
Several persons testified against the rule change because it did not go far enough. After all testimony was heard, we adopted it by unanimous vote. It appeared that the meeting was almost on track to a reasonable and painless conclusion if not a short and sweet one.
The next issue involved a Medicaid rule change that would limit brand name prescriptions to four per month while allowing unlimited generic prescriptions. It was a good faith effort to meet severe funding restrictions without limiting basic medicine to those in need.
Representative John Knight, Chair of the House committee that handles the General Fund Budget, had worked with Medicaid officials and others to develop an approach consistent with basic health needs and funding in the Medicaid Budget. I had been personally asked by the Medicaid Commissioner to move adoption of the amendment approving the rule change. I had agreed.
A few minutes prior to the meeting, Senator Roger Bedford came into my office. He mentioned that he intended to offer an amendment to delete the four-brand-name restriction for cancer patients. I was sympathetic in part because Senator Bedford is a cancer survivor. I informed him that I had agreed to sponsor the proposed rule change. He said, “Help me if you can.” I wanted to help if such a change could be made without damaging Medicaid’s ability to help all its clients.
The discussion was intense. Before I could make the motion to approve the rule change, Representative John Knight moved for adoption. I knew he was right to insist that any changes be consistent with funding appropriated. I believed Senator Bedford was right when he said, “For cancer patients, there are few generic drugs.”
On one side of the equation, strong concerns for health and life were framed within the confines of fiscal responsibilities. On the other side, strong concerns for health and life were advanced over the confines of fiscal responsibility. I was caught between a rock and a hard place. I was torn.
During the meeting, I raised the possibility of a compromise on two occasions. My efforts fell on deaf ears. Representative Demetrius Newton, the presiding officer and House Speaker Pro Tem, raised the possibility of compromise even earlier. It had also fallen on deaf ears. Severe time restraints were a factor. We were at loggerheads.
The issue was not raised during the meeting, but powerful drug interests were strongly opposed to limiting brand name prescriptions to four per month. Generics cost a fraction of brand name drugs. That reality, however, lurked just beneath the surface.
As I saw it, the Bedford exception might save some lives. On the other hand, it might result in thousands of Medicaid patients going without any medicine because so much money would be used to pay for medicine for a few. No one knew the cast of this exception. We were damned if we
did and damned if we didn’t.
After a tabling motion disposed of Senator Bedford substitute motion, I voted to approve the amendment to the Medicaid Rules as submitted. A subcommittee was appointed to make recommendations for exceptions to the four brand name prescriptions for cancer and other life threatening diseases. It must also make recommendations on paying for the exceptions.
It was the best we could do under difficult circumstances. The real problem is too little money to meet the minimum health needs of our people.
Now on to the Daily Diary.
Saturday – I left the financial conference in Biloxi and traveled to Mobile to speak at the Alabama State Employees Association Diversity Conference. I also had a book signing. I then had a second book signing at Black Classics bookstore where I talked with Senator Vivian Figures and others. I had a third book signing in Bay Minette where my family (my sister Elouise and her husband James Robinson, my brother Sam and his wife Ella Sanders, my brother James Sanders and my nephew Willie Parker among others, came to share. I then traveled back to Selma with Rita Lett, Sam Walker and Khadijah Ishaq.
Sunday- I did Radio Sunday School, Radio Education and Sunday Review. I worked on Sketches and participated on a Birmingham radio program about Death of a Fat Man.
Monday- I completed Sketches and attended a county commission meeting in Lowndes County. I returned to Selma to meet with a new business prospect. I handled various other matters.
Tuesday- I met with Team Selma and traveled to Jefferson County. I returned to Selma for a mass communication meeting and a book signing.
Wednesday – I handled various activities before traveling to Montgomery for a meeting with the Director of the Alabama Department of Transportation and others. I met with an expert about changing human behavior. I returned to Selma for various meetings and other work. I also talked individually with Senator Roger Smitherman and Senator Roger Bedford about legislative issues.
Thursday – I worked on Sketches before traveling to Montgomery for a conference concerning foundation governance. I returned to Selma to work on several matters. I then traveled to Destin, Florida for the Alabama Trial Lawyers Association Annual Conference (ATLA). I talked with various leaders from around the state.
Friday – I met with leaders of ALTA and other senators to discuss legislative issues. I also talked with various leaders and did a book signing.
EPILOGUE- My mother used to say, “Son there are at least two sides to every issue. It’s never easy but sometimes you just have to choose.” It was painful, but I made my choice at the Legislative Council meeting the day after the 2004 Regular Session ended. So did others.