JEFFERSON CITY - A more than $8 billion budget to guide Missouri's spending on social services narrowly passed the Senate early Wednesday morning after lawmakers initially defeated the measure.
Some bipartisan criticism arose during overnight debate because the Senate's increase was roughly $100 million less than the House's recommended hike.
"I'm adamant in the fact that we're going to rein in welfare growth," said lead budget writer Republican Sen. Kurt Schaefer, who aimed to trim the total budget for the next fiscal year and push the Department of Social Services to be more efficient .
But state budget director Linda Luebbering, department officials and senators from both sides of the aisle warned that the Senate's proposed budget is not enough.
The bill needed 18 votes to pass, so an initial 17-15 vote left the proposed bill hanging. But Republican Sen. Will Kraus of Lee's Summit called a motion to reconsider and in the early hours of Wednesday the bill passed 18-15.
Kraus, who first voted against the bill, said he decided to vote in favor the second time in order to allow the bill to move forward. He said he expects the two chambers to address concerns with changes to the bill as negotiators hash out major differences.Schaefer, of Columbia, said it's unclear what would have happened if senators had not approved the budget plan. The entire package of legislation for next year's budgets, including the social services bill, must return to the House before going to Democratic Gov. Jay Nixon for approval.
Lawmakers face a May 8 deadline to approve the budget bills.
Sen. Rob Schaaf, R-St. Joseph, also raised concerns about changes to how Medicaid recipients would receive treatment and filibustered for hours on a proposal in the bill that would shift 200,000 Missourians on Medicaid from fee-for-service to managed care.
A fee-for-service model requires the state to pay for Medicaid recipient health care on demand and pays physicians as patients are treated. In managed care, the state contracts with a company to oversee a patient's care and pays the managed care company directly.
Supporters of managed care, including Schaefer, said working with a contracted manager streamlines management and reduces costs. Schaaf questioned those savings, saying it would lead to a reduction in patient care, and that it was unfair to include the change in a budget bill without a public hearing.
The measure made it into the bill, despite Schaaf's concerns, although Schaefer amended the proposal to require the state's Medicaid program to contract with eligible doctors with designated coverage areas in Missouri.