Legislative Update Week of February 18th

The legislature this week continued their work on the budget for the upcoming fiscal year. The House finally has been receiving work done by the committees, allowing for consideration and for the first votes on the House floor for this young legislative session. Let's review the activities of the past week:

House:

The House Insurance committee took its last bits of testimony on Senate Bills 61 and 62, which would provide for the mutualization of Blue Cross in Michigan. The legislation came out of committee lacking the controversial abortion amendments that hampered the legislation last time, hopefully gaining support from the Governor this time without the amendments. The legislation will now head to the House floor where the amendments could be tacked on or added to the legislation, but it is accepted that the House will act on the legislation in the coming week.

Senate:

The Senate Reforms, Restructuring and Reinventing committee meet to continue taking testimony on Senate Bill 2 which would expand the scope of practice for advanced practice nurses. This legislation has been somewhat controversial in the medical community and many have found it interesting that the legislation was sent to this committee rather than the Senate Health Policy committee. It was unclear before the hearing whether or not the committee was going to take action on the legislation but in the end did not. MSMS is continuing to work with the sponsor of the legislation to find a compromise that would be suitable for all of the interested parties. We will keep you up to date on the actions of this legislation.

Appropriations:

Both House and Senate subcommittees meet this week to hear testimony from the largest part of the Department of Community Health budget, medical services or Medicaid. The expansion of Medicaid, which is a policy MSMS supports, was a hotly contested topic among the Senators while their presentation from the Medicaid director, Director Fitton. Many of the Senators on the committee had a hard time of seeing where the savings would come from if the state went ahead and expanded Michigan Medicaid program. Looking at the Medicaid 67% of the money is federal where the state only provides 16% of general fund / general purpose dollars to the program. It will be interesting to see how the expansion will play out in the coming months.

MSMS New Lawmakers Reception:

MSMS, as they do at the start of every legislative session, held its New Lawmakers reception at the MSMS Headquarters in East Lansing. The event was well attended by physicians and lawmakers alike with Senator Roger Kahn, MD and Representative Sean McCann to name a few that joined us. "This is a great opportunity to reach out to our lawmakers", said Raymond Rudoni, MD who is the chair of the MSMS Legislative and Regulations committee. The event went on past its end time and was hailed as a success with participation from medical students to retirees.

Legislative Update Week of February 11th

With the budget being presented by the Governor we're now off to the races on what can be described as an up and down next couple months for the next couple months. Blue Cross Blue Shield is still in the works in the House with the Senate waiting for the House's next move with the health insurance issues. Let's review the week:

House:

The House Appropriations Subcommittee for Community Health started its work on the FY 2014 budget by welcoming the Director of the Michigan Department of Community Health to the committee for an overview of the State Budget. Out of this presentation the Director laid out the priorities of the administration as it pertained to Michigan's health care Major topics were the Medcaid expansion, mental health, and infant mortality to mention a few. Now the committee will have presentation from Medicaid, Behavioral Health, and Office of Services for the Aging in the coming weeks.

The House Insurance committee took testimony on Senate Bills 61 and 62 which provides for the mutualization of BC/BS. The House, similar to last time, started discussions about the abortion language that was in the previous legislation and one of the major reasons of why the Governor vetoed the legislation last time. It is uncertain at this point whether abortion language will be in the bills moving forward.

Senate:

The Senate Committee on Reform, Restructuring and Reinventing took testimony on Senate Bill 2 which would define the scope of practice for advanced practice nurses which included nurse practitioners, nurse midwifes, and certified nurse specialists. This is an issue that the society is leary about but have been working tirelessly with the sponsor to answer his question on the the concerns that the medical community has with the legislation. It is uncertain at this point when the legislation will move but rumblings have said that it could be as early as next month.

Stay with MSMS to get the latest up to date information on all that is happening in Lansing and beyond at http://www.msms.org/advocacy. You support of MDPAC helps those in Lansing work better with physicians go to http://www.mdpac.org to find out how you can help.

Legislative Update Week of February 4th

The past two weeks the Legislature has started to pick up some steam with the Senate moving the blue cross mutualization part two through the Senate and the Governor presenting this budget to the Legislature, let’s review the activities of the past couple weeks:

House:

Committees have been finally formed with Rep. Gail Haines continuing her leadership as Chair of the House Health Policy committee. Rep. Matt Lori will continue his leadership as Chair of the Appropriations subcommittee on the Department of Community Health. The House Health Policy committee started it normal routine for the beginning of the year with briefings from the Department of Community Health for the new members of the committee. With the budget being presented the House Appropriations subcommittees will start to have presentations from their respective state departments.

Senate:

The Senate Insurance Committee over these past couple weeks considered the Blue Cross mutualization issue that started in the last term of the Legislature. This time the Senate listened to the Governor's recommendations in his veto of the previous legislation and passed what the Senate has passed the first time out of committee. The legislation made its way to the Senate floor where it was approved and sent to the House for their consideration where it was sent to the House Insurance Committee.

Budget Presentation:

The Governor this past Thursday Governor Snyder presented to the Legislature his recommendations for fiscal year 2014. With this announcement on Wednesday of supporting the implementation of the Medicaid expansion in Michigan the Governor set out to provide his road map for the financial future for Michigan in the coming fiscal year.

With the Medicaid expansion already being revealed, his announcement for increasing funding for Michigan's infrastructure and budgeting a 2% increase for K-12 funding, the Governor just gave the Legislature some specifics on what he wanted to do for FY 2014.

The Governor asked for increase funding for mental health services, mental health homes, and innovation programs all in an effort to support and strengthen a program that needs it. Many of Michigan's children continue to go without proper dental care, with this budget as with the last, the Governor proposes support Healthy Kids Dental by adding additional funding for the program. With the Governor's report from the task force on Infant Mortality being release middle of last year, he was unable to provide funding for any solutions that the report found, with this fiscal year that is different and proposes adding $2.5 Million to help curb mortality.

With medicine changing the need for innovation is needed now more than ever and the Governor recognizes this, and did so by adding $3 Million for innovation grants for those looking to pioneer medicine's next big breakthrough in Michigan. On the downside Graduate Medical Education took another blow with a recommendation of a cut around $7 Million.

Now it will be up to the legislature on their direction with the budget for FY 2014. MSMS will continue to track and advocate the best for all of Michigan's patients and physicians. Continue to stay with MSMS to receive updates on what is happening at http://www.msms.org/advocacy.

Legislative Update Week of January 14th

With the new session still in its infancy, the Legislature has not been able to get up to working at full speed yet. They awaited two crucial pieces of information: one, how much money they would have to budget with, and secondly the agenda and direction the Governor wanted to go in, Over the past week the Legislature received that information, let’s review:

Consensus Revenue Estimating Conference

Before the start of the new legislative session the House and Senate Fiscal Agencies along with the State Treasurer came together to discuss the estimated revenue that the state would have in the coming fiscal year at the Consensus Revenue Estimating Conference. This conference meets twice a year, in January and in May. The conference heard from both of the fiscal agencies along with the Department of Treasury. The University of Michigan was also invited to provide an economic outlook for the state in the coming years ahead. Let’s break down the numbers:

Unemployment:
The outlook for Michigan unemployment picture is slowly brightening up. With a current rate for 2012 at 8.9%, economists forecast that the overall rate for the coming year will drop a point to 8.8%; drop to 8.2% in 2014 and 7.6% in 2015.

Personal Income:
With the drop in unemployment forecasted and second positive is the forecast of increasing personal income for those working. For 2013 it has been forecasted to increase 2.6% with a 4.3% increase in 2014 from 2013 and 4.4% increase in 2015. A direction the Governor has been advocating for since his election two years ago.

State Budget:
What does that mean for Michigan? One could extrapolate that with the increase in income over the coming year that revenues for the State will be increasing. With FY 2013 though, that isn't the case. The General Fund General Purpose monies, that fund programs like Medicaid, will actually see a decrease from FY 2012 of $472.9 Million or a change of 5.1%. The School Aid fund is expected to add an additional $249 Million than what was estimated May 2012. We could see some cuts coming in programs in Michigan for FY 13 but expected an increase in revenue of $472.2 Million for FY 14. Now the Governor will present his budget proposal to the Legislature on February 7th, so we wait and see how programs will be affected.

State of the State Address

The Governor's State of the State address was just like the other he has delivered, using an outline to rather than providing an actual written speech when he delivered it. The Governor started by providing a review of where the State was with his dashboards that he has made famous over his term has Governor. The dashboard can be view by clicking the link above. The Governor reported that with the changes that Michigan has seen over the past two years, the economy in Michigan was growing and Michigan was putting people back to work.

The road ahead for the Governor looks to continue the same success that has had over the past two years. There were three major messages that Governor Snyder conveyed to the lawmakers this past Wednesday night: one an increase in funding for roads is needed and needed now. The Governor is looking to raise 1.2 Billion each year for 10 years to cover the costs of repairing Michigan's crumbling roads. This was met with hesitation by many from his own party since the plan included a large fee increase to automobile registration. Time will tell on whether this proposal will make it out of the legislature or not.

The second major proposal was educational and the increase efforts to pass an Education Achievement Authority. Fifteen schools in the Detroit area are already operating under the premise of an Authority that provides a different look at education than what is considered typical in Michigan. Students are taught to master skills without the fear of receiving failing grades and worried about whether or not they will make it to the next grade. The Governor would like to have the opportunity to bring this proposal state wide to all of the schools that are struggling in Michigan.

Finally, the third biggest topic was insurance reform. The Governor vetoed the last efforts by the legislature to reform Blue Cross Blue Shield due to the abortion amendments that were tacked on by the House in the final days of the last session. The Governor now asked the legislature to go back to the drawing board and bring legislation forward that would move the Blues in a world that had a health insurance marketplace. Auto no fault insurance was the other insurance reform topic of his speech. He wants reforms done this year to provide protection to the insurance companies on their liability and legacy costs for those involved in an auto accident. It is inevitable that this will be on the agenda of this legislature.

To get more details on the Governor's State of the State address click here.

Stay with MSMS to receive all of the up to date information at http://www.msms.org/advocacy.

Legislative Update (Special Edition)

With the Legislature finally closing its books on the 96th Legislature there were many issues that made their way through the process that kept MSMS on its toes. We provided several letters of support or opposition, provides hours of testimony to the House and Senate, and made hundreds of office visits and phone calls and e-mails. All of this truly helped shape the health policy that Michigan gained over the past two years. Now that the session is over we want to take a look at the issues that affected all of us:

Liability Reform:

Drs Elmassian and Chafty Testifying

The largest victory for MSMS this year was the passage of reforms that would bring Michigan's tort climate back toward what was originally passed by the legislature in 1993. Senate Bills 1115 and 1118 were passed by the legislature in, what some would call, a legendary lame duck session of the Michigan Legislature. These reforms did not come without the battles including five committee hearings in the Senate on these bills which lead to huge crowds in the committee rooms. Those who were for and those against the reforms packed the room wanting to make their presence known to the committee and how they felt.

View at tort reform hearing.

After hours and hours of testimony the Senate committee moved the legislation to the floor and from there the legislation had covered it first real hurdle. Deliberations, discussions, amendments, and speeches against and for the legislation lead us to the final day of working session for the legislature where the House finally took up the legislation on the floor and gave it its blessing to send it to the Governor for his signature. It has been almost twenty years since there has been some significant tort reform for medical malpractice in Michigan until the end of this session, these tort reforms will be good for physicians but more importantly good for patients.

Wayne State Medical Students
 lobbying for Tort Reform.

Earlier in the term MSMS worked on legislation that would allow those physicians who are employed to volunteer in clinics and be provided protections that are afforded to those who are retired and work in the clinics (House Bill 4350). There was contention with this legislation since it provided what some classified as blanket immunity has they had in the later tort reform debate. Working with the members of the Senate, MSMS and other parties were able to come to an agreement that would provide the protection to those who are not contractually compelled to work in clinics to receive the liability protections of those who are retired and volunteering. It was a great day for medicine by opening the door to those physicians who wish to give of their time to help those who need the help the most.

Medical Marihuana:

Dr. Newman testifying to the Senate
Judiciary committee on Medical Marihuana

In this term Medical Marihuana left us with the question of what a "bona-fide patient/physician relationship" was in the eyes of the law. In medicine that question can lead to several answers. The face to face relationship all the way to telemedicine can lead to the definition of a patient/physician relationship. The Medical Marihuana statute stated that grey area that required patients to have this relationship with their physician but did not state what that relationship looked like and left law enforcement and the medical community scratching their heads. Insert House Bill 4851 which for the purposes of Medical Marihuana defined what that relationship looked like. Now patients would have to have contact with their physicians regularly rather that a one and done visit as some were seeing for those who were looking to obtain a certification for Medical Marihuana.

Insurance:

Insurance was an issue that started right away in the session with the attempt by the House to change the Michigan Auto No Fault system. House Bill 4936 wanted to provide levels of coverage that a person can obtain that would provide a certain level of financial coverage for any personal injury that occurred in an auto accident. From the state this was an issue that MSMS was against. Legislators were looking to provide choice for those individuals who were looking to save on car insurance and also provide relief to the Michigan Catastrophic Claims Fund, the fund that covers those gravely injured in an auto accident. Proponents of the legislation stated that the changed needed to happen since in its current form it would bankrupt the system. Opponents of the legislation asked to see the numbers and in the end were never given the opportunity to see the hard data. The House Insurance committee did pass a series of reformed and sent it to the House floor for their consideration but were never able to obtain the votes. Expect this issue back again the new session.

It wouldn't be a complete legislative session if Blue Cross/Blue Shield wasn't involved in some way. This term they had the backing of the Governor and finally found a way to get out from under PA 350 or the Nonprofit Health Care Corporation Reform Act. This act provided the tax breaks that the Blues enjoyed but also provided some requirements that the Blues did not enjoy. With the impending implementation of the health insurance exchange in Michigan, the Governor thought it was time to bring a change to the Blues and give them the ability to compete in the insurance exchange among other reasons and push for legislation to reform the Blues. The Legislature responded and created a nonprofit mutual insurer in the state of Michigan and providing a path to those incorporated under PA 350 to convert into this mutual insurer. This legislation did not come without a cost, requiring that the Blues pay to the state $1.56 Billion from now until 2018. This money will be placed in a health fund used to cover health projects and subsides Medigap policies until 2021 at a cost of $120 Million a year. The Governor received his wish and Senate Bills 1293 and 1294 were sent to his desk where they await his eventual signature.

Helmets:

Before the Legislature left for the summer break this past year they decided to take up an issue that has been on the burners of the legislature for years. They finally made a decision on the age old question, should you be required to wear a helmet while operating a motorcycle? In their opinion you should not be required since it was your individual right to determine whether you ride with a helmet or not. Senate Bill 291 made its way through the legislature going through its ups and downs, being amended several time, and at one point being used in the same conversation the changes with Auto No Fault, but in the end it was finally time according to the legislature to act on this measure. MSMS was adamantly opposed to the legislation reasoning that the having helmet on in an accident will give you the greatest chance to walk away from that accident but the Governor and Legislature did not see it that way and now today we have those who cherish their individual freedoms riding without a helmet. Time will tell if this was a wise decision for Michigan.

Graduate Medical Education:

Every year at MSMS we always face small battles when it comes to the budget, whether it’s trying to get more money for Medicaid, trying to stop the cut to public health funding, or trying to keep J-1 visa waivers in the budget we always have some small battles. One that always continued to come up and we feel will continue to, is the funding for Graduate Medical Education. The Governor has presented his last two budgets to the legislature with significant cuts to the program citing that the priority should be funding Medicaid at a higher level so that physicians will service more patients on Medicaid rather than funding the training of new physicians, fresh out of medical school. We see and understand the investment on Graduate Medical Education and what care this provides to those who need to care the most. Through work and education of the legislators we have been able to stay away from the deep cuts proposed by the Governor and only work hard to absorb small cuts from the legislature. In the coming years we will have to continue this fight to keep GME at its current level rather than seeing another cut to the program.

Affordable Care Act:

This is the only federal issue that made out list this year. We all know about the sustainable growth rate (SGR) and how we face looming cuts into Medicare but somehow Congress always finds a way to kick the can down the road. This time we think it will be the same but with the fiscal cliff casting a shadow on other impending issues, it could take some serious lifting by Congress to get this done on time.

US Supreme Court rendering opinion
in Affordable Care Hearings.

But now on to the Affordable Care Act and the decision from United States Supreme Court that some say rocked and other say solidified the nation in the future of its health care. The Supreme Court upheld the law saying that it was in the taxing authority of Congress to mandate insurance for people and was not within the commerce clause of the US Constitution. This left many states that were waiting for a decision under the gun if they were going to start creating their own health insurance exchanges. As for Michigan an attempt was tried with legislation that was sent from the Senate to the House, Senate Bill 693, but failed to gain the proper support from the committee. The state will now have a state/federal partnership exchange in 2014.

Scope of Practice:

This year the Medical Society found itself involved in looking at the future of medicine and how the team approach to care can continue to grow in Michigan. At the start of the term, physician assistants and physicians came together to find ways to grow their partnership in Medicine and came out of those discussions with Senate Bill 384 which brought more clarification on the relationship between PA's and Physicians, strengthening it, providing greater avenues to provides the best care.
Physical Therapists made an attempt this year to provide direct access for patients, bypassing the physician in House Bill 4603. Nurses also were looking for some clarification on their profession and how they fit into the team approach of medicine with Senate Bill 481. Both of these pieces of legislation did not make through the entire legislative process but MSMS is looking forward to continuing discussions with these groups to better strengthen the medical team in Michigan.

Autism:

Dr. Phillip Wise with Lt. Governor
Brian Calley at the signing of the Autism
Legislation.

This legislative term saw the largest advancement in mental health parity in Michigan in decades. MSMS has always had a long standing policy to support mental health parity in the insurance coverage of treatment of mental health conditions. Michigan took a step towards that this term by requiring the coverage of services surrounding the treatment of Autism. This was a priority of the Lieutenant Governor, Brian Calley; an issue that he worked hard for when he was a member of the Michigan House. Senate Bills 414, 415, and 981 started in June of 2011 with 981 adding in March 2012 and by April 18, 2012 it was the law of the land that insurers had to start to cover Autism services and treatment in Michigan. This is one small victory towards the larger goal of mental health parity.

Claims Tax:

Starting in 2011 there were rumblings from the federal government that the use tax that was set up by Michigan to tax the insurers that held Medicaid plans in Michigan was going to be ruled illegal and could penalize the State by holding back funds for Michigan's Medicaid program. A dilemma was presented to the legislature on what to do to replace the revenue needed to obtain the funds needed for Medicaid. Thus the claims tax proposal was created. Senate Bills 347 and 348 eliminated the use tax and created a claims assessment or tax on each of the insurance claims filed at a 1% level in Michigan. This was supposed to solve the revenue shortfall that would come with the elimination of the Use Tax but that as time moved on it proved not to be the case and this year the Medicaid faces a $140 Million shortfall that has to be filled somehow. The Senate tried to move Senate Bill 1359 which would provide an adjustable rate to make the need for revenue but was rejected by the Senate Appropriations committee. The legislature continues to look for solutions for the shortfall.

Abortion:

Abortion was an issue that seemed to be on the forefront this term with the legislature as looked tightens up regulations surrounding this hot button issue. There were several bills introduced and has testimony taken but in the end, these bills were placed into one large bill House Bill 5711. This legislation took a look at four major issues the legislature felt needed to be addressed: the licensing of facilities that perform abortions, the disposal of remains, and the liability protections needed by a physician who performs abortions, and the use of telemedicine in an abortion. Those against this bill called this issue the War on Women and continued to push for its stall in the House and the Senate. Those efforts did fail and in the early morning hours of the last day of session, the House concurred with the Senate and sent the bill to be enrolled and presented to the Governor. It’s currently uncertain if the Governor will sign the legislation.

Abortion found its way into the blue cross mutualization changes mentioned above with amendments that were added by the House to require that coverage for elective abortions be an opt-in coverage rather than an opt-out situation when purchasing coverage. We will have to wait and see the impact it will have on Michiganders.

Impaired Drivers:

Dr. Spanaki testifying with Senator
Schuitmaker on Senate Bills 402 & 403

An issue that MSMS has been working on for several years was finally accomplished this legislative term by providing liability protections for physicians who report to the Michigan Secretary of State that a person may be impaired to operate a motor vehicle. Senate Bills 402 and 403 started in the Senate Transportation committee and made their way through the entire process landing on the Governor's desk at the end of the second week of December. With the Governor's signature on this legislation physicians can report those patients they feel should not be operating a motor vehicle and let the Secretary of State decide whether that individual should be driving.

Bullying:

A major issue for the MSMS Alliance with past term was the creation of regulations for schools on how to handle instances of bullying. House Bill 4163 was created to provide the school districts have plans in place to handle bullying and plans that are specific to their school district but meet certain requirements required in the act. In December of 2011 Michigan joined other states by have the Governor sign Matt's Safe School Law into law.

Concussions  and High School Athletes:

Watching local high school sports over the past several years there continues to be a push to be faster, be stronger, hit harder and just become more physical overall. With this drive the amount of concussions happening in High School athletics was rising sharply leaving physicians, parents, coaches, and school personal concerned for the safety of the students playing athletics. This lead to the introduction of Senate Bill 1122 and House Bill 5697. Both of these pieces of legislation set into motion procedures that needed to be taken by school personal, what clearance was needed to be obtained by the athlete to compete again and what literature was needed to be provided to the athletes and parents on concussions and their treatment. We are hopeful that this will protect those athletes that want to compete at their highest levels.

With a busy legislative term over, MSMS is looking forward to what the next legislative term will bring. Some of the same issues mentioned today could very well make their way back into the legislative picture in the coming term. Stay with MSMS to get the latest information on issues going through the legislature that affect you and your practice at http://www.msms.org.advocacy. We will be taking a break now until the start of the new term, hope you all have a great new year!

 

Legislative Update Week of December 10th

The final week of lame duck came to a close around 4:30am today, signalling the end of the work being done by the 96th legislature of Michigan. This final day did bring a flurry of issues though the House and Senate including money for a new arena for the Detroit Red Wings, replacement for the emergency manager law, repeal of the personal property tax, and the Detroit lighting authority just to name a few, lets take a look at the issues that will effect you:

Tort Reform:

The House Judiciary committee took up the tort reform bills that made their way from the Senate. Senate Bill 1115, 1117, and 1118 were considered in committee. The committee had a litany of legislation that it needed to consider on this past Wednesday. The committee finally was able to support 1115 and 1118 and sent them to the full House for their consideration. On the last day of session the House took up the remaining bills in the package and by 5:10pm, the House was sending to the Governor legislation that would be the most substantial tort reform that Michigan has seen for medical malpractice since the early nineties. Rumors have been floating around that the two other bills that did not make it through the process will be reintroduced in the coming term.

Abortion:

The House and Senate this week traded legislation, House Bill 5711, that addressed several issues surrounding abortion. One would make it illegal to perform an abortion on a woman who has been coerced into receiving one. Secondly there would be licensing requirement for those facilities that would perform abortions and would require reporting to the Department of Community Health. More information on the legislation can been seen at the link above.

Conscientious Objectors:

The House Insurance committee considered Senate Bill 975 which would provide the protection to physicians who chose not to perform a certain procedure due to a religious or moral objection. MSMS submitted a letter to the committee expressing some concerns we had with the legislation but more importantly praised the efforts of the sponsor of the legislation with his willingness to work with the medical community to address those concerns. The legislation did make it out of committee but did not make it out of the House. MSMS expects to work again with the sponsor in the coming term on the legislation.

With the legislative term coming to a close, we will be taking a break for a little bit. Check in next week as we will have a review of the legislative term discussing the issues that MSMS has worked on for the past two years. Comments are always welcome and we want to hear from you. We have a comment section with every article, please feel free to leave one. Keep up with all advocacy efforts at http://www.msms.org/advocacy.

Legislative Update Week of December 3rd

View of the wait into the House gallery.

Week two of the lame duck session of the legislature continued to offer excitement, fireworks, and even an arrest or two around the Capitol. The week started out with not knowing what the House was going to do with the Blue Cross mutualization legislation that was in the House Insurance committee. Rumblings of Right to Work legislation lead to an all out confrontation between union and legislators on Thursday. Lets review the week:

House:

The House Insurance committee finally meet after session on Wednesday to bring the agreement that the House, Senate, and Governor could agree to. The committee passed the legislation to the House Floor where it was amended again with final language that needed to be added. What was added? A fix for those who have medigap policies. The bill now requires the fund set up by the conversion to pay $120 Million yearly to subsidize the medigap policies until 2018. The House also added an elective abortion amendment that would require those who want to have coverage for an elective abortion to "opt in" for that coverage. The package will now head to the governor's desk for his signature.

The House Health Policy committee was scheduled to meet but with the Right to Work legislation being worked on that day, the committee was canceled.

Senate:

The Senate had a couple other items on their agenda that was health related this week, but as it was with the House, it was all about Right to Work. The Senate passed a series of three bills that made it illegal for those in the health insurance exchange to offer coverage for elective abortions unless the patient purchased an "opt in" coverage for the procedure. The package was sent to the House where it could be taken up since the House did consider some other controversial abortion regulations earlier in the year.

The Senate also considered and passed Senate Bill 975 despite some objections from the major medical groups. What this legislation would do, would provide protections for a physician who chooses not to treat a patient based on their religious beliefs. This raised several concerns to Senator , Kahn, a cardiologists, on the Senate floor saying that it goes against the oath that physician's take before entering into practice. The bill will now be sent to the House where with limited time in the legislative year probably will stay.

The House and Senate have one more week to consider items before they leave for the year. Tort Reform is expected to be taken up this week. Stay with MSMS at http://www.msms.org/advocacy to get the latest information on all of the action happening at the Capitol.