Wash Business Journal: DC Budget/Medicaid Mess

D.C.’s budget mess

D.C. gets $58M Medicaid bill, refuses to pay

Washington Business Journal – by Michael Neibauer

Date: Thursday, October 28, 2010, 2:49pm EDT

The District, already facing a $200 million-plus shortfall this year and $400 million the next, may have to scrounge up millions of dollars more to reimburse the federal government for bad Medicaid claims.

It’s not supposed to happen this way. The District generally bills Medicaid, not the other way around.

But the Centers for Medicare and Medicaid Services, in an Oct. 18 letter, called for D.C. to pay back $58.75 million it received from Medicaid in fiscal years 2004 and 2005 — for charges the city cannot support. The District’s Department of Health Care Finance, which oversees Medicaid and Medicare, responded days later that it rejects the bill, disagrees with the charges and plans to appeal.

DHCF “disagrees with the Centers for Medicare and Medicaid Services’ findings,” Julie Hudman, DHCF director, wrote Oct. 22 to Ted Gallagher, CMS associate regional administrator in Philadelphia.

“Additionally, because we disagree with your findings, when we receive the official disallowance letter, we will be appealing the disallowance to the Department of Health and Human Services, Department Grant Appeals Board,” Hudman wrote.

LaShon Beamon, DHCF spokeswoman, said the rejection letter was a “formality” to get the matter to the next step — an administrative hearing, where Medicaid may offer some relief.

“Maybe we’ll pay half,” she said. “Maybe none.”

Blame for the billing blunders falls mainly at the feet of the Child and Family Services Agency, which has a history of improperly submitting and poorly documenting its Medicaid claims (as does, to a lesser extent, the D.C. Public Schools). The problem was so pervasive — threatening the city’s financial reputation on Wall Street — that D.C. stopped requesting Medicaid reimbursement for CFSA-related targeted case management and rehabilitation charges as of Jan. 1, 2009.

The city wrote off nearly $100 million in anticipated Medicaid revenue in fiscal 2009 and 2010. Doing so limited the risk of overbilling in the future, but CMS still wants payback for mistaken claims of the past.

“CMS has proposed a repayment schedule, which the District has rejected,” Lorraine Ryan, spokeswoman for CMS Region 3, said in an e-mail. “As a result, CMS will initiate a disallowance in order to resolve the overpayments. The District has the option of appealing the disallowance.”

But there is no denying that the overbilling happened. The issues were revealed by internal audits conducted on behalf of the District’s Medicaid program.

Health Care Finance will not restart CFSA-related Medicaid charges for targeted case management until its private sector Medicaid manager — what’s called an Administrative Services Organization — is on line. That won’t happen until the spring, Beamon said.

Read more: D.C. gets $58M Medicaid bill, refuses to pay | Washington Business Journal

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New Republic: Obama’s Redirect — to the States?

Forget About Boehner. Try Republican Governors

  • Harold Pollack
  • October 29, 2010 | 12:00 am

This is the fifth in an occasional series examining how Republican control of Congress might affect policy debates in the next two years. (Part 1, Part 2, Part 3, Part 4)

Supporters of health reform are asking how President Obama might find common ground with House Republicans should Tuesday’s elections go badly. Count me as a pessimist on this front. House Republicans have perceived little reason to compromise on health reform or much else. For many, ideological principles and political incentives converge on one destination: Implacable opposition to the centerpiece initiative of the Obama presidency. Midterm victories would not soften conservatives’ policy views or this basic strategic judgment.

Republicans won’t have the votes to repeal the new law. They also face three awkward realities. First, the Affordable Care Act’s most unpopular provisions fill budget holes Republicans couldn’t easily fill. Second, specific aspects of ACA–such as those which forbid insurers from discriminating against sick people–are genuinely popular. Third, outright repeal would focus public attention on Republicans’ own proposals, something the Republicans would wisely avoid.

If they cannot repeal ACA, Republicans can greatly damage it. They can hold interminable hearings to rattle the Obama administration, publicize bureaucratic goofs, and perhaps uncover a workable scandal. They can underfund and otherwise undermine ACA’s implementation–and then blame the Obama administration for the resulting snafus.

The farcical “1099 collation calamity” exemplifies the latter strategy. To make a long story short, ACA raised roughly $18 billion by imposing rather cumbersome paperwork requirements to reduce tax evasion by small businesses. Small businesses didn’t like it. Democrats mustered 56 Senate votes for a reasonable fix, but Republicans blocked the vote. Having prevented Democrats from addressing the problem, Republicans have been happily running on this ever since.

House members have no day-to-day responsibility for the instruments of government. They face little political penalty if they damage these instruments, or if they undermine the quality of programs they disdain. Indeed the political incentives often run the other way.

Fortunately, President Obama has one way out. He can reach out to Republican governors who actually have some stake in ACA’s success. Establishing workable partnerships with these officials provides the best hope for productive negotiation with Republicans in Washington. It also happens to be the best pathway to sound policy, in implementing one of the most complex pieces of legislation ever enacted.

Governors are promising partners because they bear actual responsibility for millions of uninsured patients. They must respond to TV news accounts of uninsured cancer patients denied care. They must balance their budgets in the face of recession and rising costs health care. Elected by entire states rather than by narrow gerrymandered districts, they have some reason to present themselves as pragmatic dealmakers who get things done.

Governors need federal help and money to establish working health insurance exchanges on a tight timetable. ACA also expands funding for community health centers. These are essential to address the crush of uninsured people, particularly immigrants. These also provide thousands of jobs. If the House defunds ACA implementation, the first political victim will be the Obama administration. The second will be governors, Democrat and Republican, who will be held accountable for the resulting mess.

Governors also have a stake in ACA’s fine print. Pre-Existing Condition Insurance Plans (PCIPs) are now operational. For the next three years, these arrangements will provide $5 billion to cover the medically uninsured. Republicans sharply criticize PCIP. Senator Enzi and thirty Republican colleagues sent HHS Secretary Kathleen Sebelius a sharply-worded letter, citing expert estimates that PCIP is underfunded. The letter asks pointed questions about what will happen if PCIP is oversubscribed or run out of funds.

These criticisms are disingenuous, since Republicans propose their own similar arrangements which are more seriously under-funded. Still, PCIP obviously requires additional resources. The proper ask from a Republican governor could be very helpful in securing greater resources.

Over the long run, governors have good reasons to support federal policies to reduce states’ heavy fiscal burdens. Republicans complain about “unfunded mandates” embodied in health reform. This is also rather disingenuous. ACA provides states with substantial resources for Medicaid expansion and other challenges. ACA also subsidizes coverage for millions of low- and moderate-income people in red and purple states where the need is most acute. Ironically, in legislative negotiations for both the stimulus and ACA, Senate deficit hawks curbed liberal measures which would have lessened financial burdens on state governments.

Be that as it may, states will require federal financial help for years to come. Liberals have a special stake in providing this help, because state budget crises are killing progressive government. A permanent increase in the federal government’s Medicaid match rate is especially essential. States cannot reliably support continued increases in required Medicaid spending. Scrambling to make budgets work, they under-pay providers. They fail to operate Medicaid with the care, professionalism, or humanity that recipients deserve. There is no way to resolve this without large infusions of federal resources.

Will Republican governors play ball? Who knows. Above the fold, many bitterly oppose the new law. Below the fold, word from the field is that many are reasonably cooperative with federal officials as both sides confront the mammoth implementation challenges of health reform. Many states are publicly or privately seeking more federal resources.

States and the federal government are locked in an uneasy partnership. This arrangement has many downsides. At least it produces Republican partners with a stake in effective government. In this Tea Party era, that’s no small thing.

Harold Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago.

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POLITICO: Races to Watch Tuesday Re Health Care Reform

http://www.politico.comhttp://www.politico.com
Races we’re watching
By: Jennifer Haberkorn
October 29, 2010 04:37 AM EDT
Six months ago, the midterm elections were expected to hinge on the recently-passed health care reform legislation, which had awoken a contingent of anti-big government conservatives. Since then, the economy and job creation has taken its place as the prime issue in races across the country.

Health took a backseat, but it never went away.

Health reform, along with the stimulus, formed the basis for an anti-government backlash among voters that some Democrats were never able to shake. Republicans based their rally cry around repealing the extensive legislation, even though they won’t have the practical tools to do it for at least two years.

If Republicans win a commanding majority of the House on Tuesday, as expected, Democrats are likely to publicly question whether passing the health reform legislation was worth it.

Health reform has played a more prominent role in some races more than others. The results here could send signals for how lawmakers and 2012 candidates implement and talk about the health care law. Here are five races we’re watching:

Wisconsin Senate: Sen. Russ Feingold (D) vs. businessman Ron Johnson (R) – Feingold has been one of the most aggressive supporters of the health care overhaul on the campaign trail, while some of his Democratic colleagues have been hiding their voting record.

A win by Johnson on Tuesday could convince Democrats that there is no viable way to spin the health reform law.

Feingold went up with several television spots in recent weeks arguing he is taking on the insurance industry to protect Wisconsin residents while Johnson – who entered the race because of health reform and is promising to repeal it – would defend insurers in Congress at the cost of consumers. One of the ads features Wisconsin residents demanding “Hands off my health care,” to Johnson.

“Feingold has used the issue in a very interesting way,” Celinda Lake, a Democratic pollster, told reporters at a forum by industry publication Health Affairs this week. “He used his health care ad to show he’s taking on the health insurance industry.”

But Republicans say that Feingold has shot himself in the foot by making his re-election campaign about health reform.

“Feingold is as good as an example as any of where the health care reform bill has been a point of debate,” said Whit Ayres, a Republican pollster and president of Ayres, McHenry & Associates. “I think that’s the reason Senator Feingold is going to be ex-Senator Feingold.”

North Dakota House (at-large): Rep. Earl Pomeroy (D) and Rick Berg (R) – Pomeroy was once held up as the moderate Democrat who could win in November on health reform.

Late last month, he began running ads saying he voted for the law to stand up to the insurance companies and protect North Dakotans, Medicare and rural hospitals.

Former Senate Majority Leader Tom Daschle, who helped craft the legislation said earlier this month – when Pomeroy’s ads defending the law were up – that a Pomeroy victory could prove to Democrats that reform is a positive for them.

“If he wins and he wins over the basis of his campaign over these least couple weeks for his advocacy for health care, it is just going to destroy all the punditry and conventional wisdom about health care and how to position yourself as you go forward,” Daschle said, as reported by the Huffington Post.

But since then, Pomeroy has changed his tune. In recent days he’s gone up with television ads hinting that he acknowledges voters are frustrated. “I know I’ve disappointed you with a vote here and there. But you can always count on the fact that I do what I do for the right reason, or the people of North Dakota.”

Governors: If Republicans pull off a wave of victories in the nation’s statehouses, a blockade against the reform law could follow in the states. Governors will be in a key position to stall or block enactment of pieces of the law.

Doing so would make reform supporters’ job more difficult. They argue that once Americans can see or feel the benefits of the reform legislation, they’re more likely to support it. Governors will be in a position to make that conversation easier or more difficult.

Beginning next year, governors and state legislators are going to have to start setting up pieces of the law, such as the insurance exchanges, where consumers will buy insurance after 2014. Governors can also encourage or stop their state agencies from applying for grants, reviewing insurance rates or participating in the law.

“Governors are going to have a great deal of control on how things come out,” says Kavita Patel, director of the health policy program at the New America Foundation. “You could have states potentially flipping from a Democrat or moderate Republican to a more conservative Republican who doesn’t want to do anything. It would roadblock the expansion of health insurance reform.”

To be sure, the law has fallback plans, in which the federal government would implement many of the reforms if the states choose not to.

Minnesota Gov. Tim Pawlenty, a Republican with an eye on the 2012 presidential campaign, has been the most outspoken governor against the law until now. Other Republican governors likely to take a lead role in opposing the law if they win on Tuesday are Kansas’s Sam Brownback and Ohio’s John Kasich.

Governors also have to contend with the 2014 expansion of the Medicaid program while dealing with stretched state budgets. The expansion is of Medicaid is going to be particularly important in California and Florida, which, combined, account for 30 percent of the Medicaid population.

New York House (24th District): Rep. Michael Arcuri (D) and Richard Hanna (R) – Rep. Michael Arcuri, a freshman moderate, was one of five Democrats to support the House’s health care bill and later flip to oppose the Senate version when it came back for a vote in the House in March.

Since then, he’s been forced to defend not only the first vote but also the image that he’s a flip-flopper – a charge Hanna threw at him before Arcuri actually cast the second vote. He’s now in a down-to-the-wire race with Hanna. Arcuri’s opposition to the law has been viewed as a plus, but it’s still unclear whether it’s done enough to save him.

California Insurance Commissioner: Mike Villines (R) and Dave Jones (D) – The Golden State’s next insurance commissioner will play a key role in health reform implementation, as well as reviewing insurance industry rates in an important state.

“Insurance commissioners throughout the country are going to have a significant impact on how [insurance] rate review is carried out,” says Dylan H. Roby, a research scientist at the UCLA Center for Health Policy Research. The commissioners will also be responsible for overseeing insurers.

Insurance rate changes are likely to continue to play a key role in the health debate. Outcry over a 39 percent rate increase proposal in California last winter gave Democrats a convincing argument that their health reform legislation was needed to crack down on insurance companies. Future rate increases are likely to be held up by reform opponents as a sign that the law is failing. Supporters of the law have already tried to preempt that claim by arguing that insurers are gaming the system and blaming reform without merit.

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Exchange Early Innovators Program

http://www.politico.comhttp://www.politico.com

States fear health care portals’ costs
By: Jennifer Haberkorn
October 29, 2010 05:00 AM EDT

The administration is asking the states to help craft one of the most expensive and technologically complex pieces of the health care overhaul.

The legislation requires by 2014 that all states have health insurance exchanges, or portals similar to Travelocity or Orbitz, where consumers can compare insurance plans and purchase coverage. They’re designed to make it easier for small businesses or individuals to buy coverage and figure out if they qualify for the health reform law’s tax credits or other state assistance, such as Medicaid.

But states view the project as an enormous undertaking, requiring them to design a system, develop the information technology and put it into action in just three years amid tight budgets. In response, the Department of Health and Human Services is planning to ask five states to develop systems that can hopefully serve as prototypes for other states to replicate.

“As we’ve been out with the states talking about 2014 and the possibility of as many states as possible doing their own exchange, they’re most concerned about the IT piece, [saying] it’s going to be expensive and it’s going to take some time,” said Joel Ario, director of health insurance exchanges at HHS’s Office of Consumer Information and Insurance Oversight.

HHS is planning to announce the program, dubbed “Early Innovators,” on Friday. States will have to apply for it and will receive grants to fund their work. Ario said the agency hasn’t yet determined how much money will be available.

“We didn’t want to put a constraint on it,” Ario told POLITICO, adding that the agency hopes for creative proposals.

Ario says the program will likely make it easier for other states to establish their own exchanges. The health reform law requires the federal government to set up the programs if the states don’t.

The agency also doesn’t want the states to feel that they have to reinvent the wheel 50 times over.

HHS says states will have to have already started on planning for their exchanges to qualify for the program. Several states, such as Wisconsin, California and Pennsylvania have already formed task forces to start setting up the exchanges and other reform-related programs.

On the other hand, some states have resisted participating in anything related to the health reform law for political reasons or hope that it will get overturned in court.

Kevin S. Wrege, Esq.

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Insurance & Financial Advisor: CareFirst BCBS to Cut Agent Commissions 15%

Updated at 2:03 p.m. ET, Oct. 25, 2010

Insurance brokers, nervously waiting to see how health reform will affect their compensation, have been told by Maryland’s largest health insurer that small-group commissions will drop by 15%, starting next year.

CareFirst BlueCross BlueShield, based in Owings Mills, Md., notified brokers of the change to payments for brokering policies for groups of two to 50 workers in a notice sent out last week, according to a Baltimore Business Journal report. CareFirst officials declined to provide a copy of the letter to IFAwebnews.com.

“As is the case with all insurers, CareFirst must operate in a new environment which requires us to achieve greater efficiency while ensuring that consumers get the most for their health insurance dollar,” said Michael Sullivan, a CareFirst spokesman, in a statement provided to IFAwebnews.com. “The adjustments we have made to our compensation and incentive structure for brokers, administrators and distributors reflect this new reality.”

Days after the passage of the reform law in March, CareFirst’s president and CEO, Chet Burrell, told agents that reform could “atomize” the small-group market nationally.

His statement in part was based on the requirement, starting next year, that insurers comply with a new medical loss ratio. That new ratio will necessitate that at least 80 cents of every dollar of premiums paid must be put toward medical expanses in the small-group market. Maryland law currently requires health insurers to put 75% of small-group premiums paid toward medical costs.

Expenses expected to fall outside the medical cost portion include marketing, broker compensation and administrative fees.

Other broker payments will change as well, depending on the rate brokers negotiate with employer groups, according to the newspaper. For large-group clients, the add-on commission, usually 5%, will shrink to near 3.5%, meaning brokers will need to negotiate to obtain the remainder from the employer group, the Baltimore Business Journal reported.

CareFirst provides health insurance in Maryland, Northern Virginia and Washington, D.C.

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WSJ: The State of the Health Care Market

Intriguing editorial on the relative role of carriers and providers in the health care market, and the risks of consolidation.

Big Insurance, Big Medicine

ObamaCare is already driving a wave of health-care consolidation—and higher costs.

ObamaCare’s once and future harms have been well chronicled, but the major effects so far are less obvious and arguably more important: A wave of consolidation is washing over the health markets, and the result is going to be higher costs.

The turn toward consolidation among insurance companies is not new, and neither is it among doctors, hospitals and other providers. Yet the health bill has accelerated these trends, as all sides race to anticipate and manage political risk and regulatory uncertainty. This dynamic is leading to much larger hospital systems and physician groups, and fewer insurers dominated by a handful of national conglomerates. ObamaCare was sold using the language of choice and competition, but it is actually reducing both.

The first surge will come among the 1,200 insurers doing business in the U.S., given that a major goal of ObamaCare is to convert these companies into de facto public utilities. Those regulations are now being written—and once they’re up and running some medium-sized carriers will collapse under the new mandates and higher overhead. State insurance commissioners warned the Administration this month that “improper or overly strident application . . . could threaten the solvency of insurers or significantly reduce competition in some insurance markets.” They also implied that bankruptcies are likely.

With these headwinds, investors and Wall Street analysts are now predicting a lost decade for health insurance stocks. But it may be more accurate to say that there will be a lot of losers and some very big winners. Mergers and acquisitions will increase dramatically once companies get a better look at the regulation and figure out the valuation of M&A targets. Larger carriers will swallow smaller ones quietly before they fail.

Both publicly traded and nonprofit insurers have been heading in this direction for years, as in any industry where there are returns to scale. Size is also important in a low-margin business in which capital is costly and political clout vital. But scale is far more central now, because ObamaCare standardizes benefits. Once insurers lose the freedom to design their own products, they’ll essentially be selling commodities, and survival will depend on enrollment volume and market share.

The same thing will happen to stand-alone and community hospitals—always a precarious business. Nearly a third of U.S. hospitals are currently operating in the red and will get steamrolled by ObamaCare, and many of them will be annexed by national chains and larger local systems.

This trend got a preview two weeks ago when Mercy Health Partners announced that it was seeking buyers for three Catholic hospitals in northeast Pennsylvania. CEO Kevin Cook told local media that ObamaCare was “absolutely” a factor in the decision to sell, only to backtrack once his comments were used in campaign ads against House Democrats Paul Kanjorski and Chris Carney, who voted for the bill.

Though it received little attention over a year of debate, ObamaCare actively promotes provider consolidation. Writing this summer in the Annals of Internal Medicine, Nancy-Ann DeParle and other White House health advisers argued that “The economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups.”

Ask and ye shall receive. Across the country, providers are building giant hospital systems and much tighter doctor alliances like multispecialty groups to get out ahead of a concept known as “accountable care organizations,” or ACOs. To modernize the delivery of medical services, ACOs would encourage doctors to work in teams to use resources more efficiently, streamline treatment and improve quality. The model is the Mayo Clinic and other large integrated systems.

At the moment ACOs are only a gleam in some bureaucrat’s eye, and no one has a clue how they’ll operate in practice until the government releases a working regulatory definition next year. Yet the percussive effects are already being felt across medicine.

Hospitals are now on a buying spree of private physician practices in the rush to build something that will qualify as an ACO. Some 65% of doctors who changed jobs in 2009 moved into a hospital-owned practice, while 49% of doctors out of residency were hired by hospitals, according to the Medical Group Management Association. In its 2010 census, the American College of Cardiology reports that nearly 40% of private cardiology groups are currently integrating with hospitals or merging with other practices.

Doctors are selling because complying with the ever-growing list of mandates has become more cumbersome; and while staff physicians on salary do gain predictability, they also lose the autonomy of independent practice. The other problem is price controls in Medicare, which are about 20% below private payments for doctors and 30% lower for hospitals. Hospitals are also scooping up practices to lock in referral sources and make up for ObamaCare’s Medicare cuts. As it is, two-thirds of hospitals lose money today on Medicare inpatient services, according to Medicare.

ACOs are also driving consolidation among hospitals. Anecdotally, Marquette General Hospital and Bell Hospital formed a strategic ACO partnership in July that will dominate Michigan’s upper peninsula. In Omaha, Methodist Health System and the Nebraska Medical Center recently followed suit. Similar alliances are underway in Detroit, Baltimore, Chicago, greater Boston, Roanoke and southwest Virginia—even Youngstown, Ohio.

The accountable care movement could do some good if it spreads best practices. But no one should entertain the illusion that it will reduce costs perforce and “bend the curve.” In fact, the most concrete effect of this wave of consolidation may be to increase private health spending significantly.

Unlike Medicare and Medicaid, private reimbursement rates are determined by negotiations, often highly antagonistic. Insurers always attribute premium increases to the underlying cost of care, while doctors and hospitals always argue that there isn’t enough competition among health plans. Both claims are “true,” some of the time—but it depends on which side has more market power.

Insurers extract lower rates by steering patients and revenue to certain providers through their networks. Providers gain bargaining leverage when health plans can’t credibly threaten to exclude them, whether because their share of the market is too large or due to public demand for “must have” hospitals. Consolidation will increasingly feed off itself as providers and insurers vie to get the whip hand in rate negotiations.

Most neutral experts believe the balance of power has tipped toward providers over the last decade, though this isn’t always anticompetitive. Higher rates generally reflect investments in staffing, technology, specialization and sometimes consumer preferences. There is also the cost-shift to private insurance to offset Medicare’s price controls. However, most economic studies on hospital M&A over the last two decades show that consolidation increases unit prices, though there is significant disagreement over the magnitude.

Accountable care organizations may become little more than a pretext for building up market power and fixing prices. The American Medical Association wants the government to stop insurers from individual contracting in favor of “exclusive dealing arrangements” with ACOs. In effect, the AMA wants a mandatory collective bargaining tool that would convert ACOs into unions.

***

“In a lot of states, the problem is just you don’t have competition at all,” President Obama said in February at his health summit. “We want competition.”

Yet the consolidation wave is churning the insurance markets and reshaping clinical medicine with almost no public scrutiny. A rational system would give consumers an incentive to reward those businesses that innovate and deliver higher quality at lower cost, whether they are providers or insurers. ObamaCare is already moving the U.S. even further from the rational world, and this forced retreat will continue the longer it is left in place.

Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved

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Wash Examiner: Kwame Brown Weighs in on Budget

Kwame Brown raises his voice on policy

By: Freeman Klopott
Examiner Staff Writer
October 22, 2010

Kwame Brown, the city’s likely next D.C. Council chairman, is exerting his own policy vision in the face of a growing council power void.

Councilman Brown hasn’t always been the most decisive member of the council. He voted present for Attorney General Peter Nickles’ confirmation, a move that put him on the books without having to commit.

But in recent weeks, Brown has started pushing his own policy.

It wasn’t long after D.C.’s current council chairman — and likely next mayor — Vince Gray told The Washington Examiner that he’s looking at slicing revenue before raising taxes to close the city’s $175 million budget gap, that Brown said he wants to make sure those who owe the city money pay up before the budget is cut. Brown has been at the table with Gray and Mayor Adrian Fenty as they prepare the cuts the council will have to consider.

“We have a budget issue and I clearly have been working closely with Chairman Gray,” Brown told The Examiner. “Going after people who owe us money is one step in a three-step process.” First get the cash that’s owed, then the budget cuts, and then consider tax increases, he said.

By playing a slightly different tune from Gray, Brown is starting to push his own vision for the council and the role it will play as the potential foil to a future Gray administration.

“What you have is the chairman-elect and the mayor-elect working together as the two leaders who will need to move this city forward,” Brown told The Examiner. Working on the budget “is an example of how we’ll work together as we move forward and as two equal branches of government.”

Gray is all but running the city now as Fenty fades into the finish of his lame-duck term. Since winning the Democratic primary, Fenty has given Gray the hiring freeze the current council chairman asked for and promoted Gray’s pick of Kaya Henderson to interim schools chancellor when Michelle Rhee announced her resignation.

But that has left the council without a clear a voice of its own. Brown, political observers say, is now becoming that voice.

“The current chairman is moving on to become the mayor and is exercising his authority,” Fenty’s former campaign chairman Bill Lightfoot said. “Brown is taking appropriate action to fill the power and policy vacuum.”

fklopott@washingtonexaminer.com

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