- Associated Press - Tuesday, March 4, 2014

Springfield News-Leader, March 2

Time for real loan reform:

A proposed overhaul of Missouri’s payday loan regulations in the General Assembly is a poorly disguised effort to benefit a rich and powerful industry that preys on the poor and powerless.

The legislation, which passed easily out of the Senate last month on its way to the House, would prohibit a borrower from renewing a short-term payday loan. Current law allows such a loan to be renewed up to six times.

But, in a nice turn for the payday lenders, it removes any ceiling on interest charged. Its sponsor, Sen. Mike Cunningham, R-Rogersville, says the interest cap is unnecessary if loans cannot be rolled over.

It all sounds logical - until you add up the realities. Current law caps interest and fees at 75 percent of the loan, which is also limited to $500 and can run only 14-31 days. That translates into an annual interest rate of 1,950 percent for a 14-day loan. Despite already being able to charge interest rates that would make Shylock blush, under Senate Bill 694, the sky’s the limit.

Outlawing rollovers does not really stop borrowers from extending a loan over and over again, eventually owing thousands of times the original amount. With lenders willing to simply make a second loan immediately after paying off the first one (or, based on proudly displayed signs throughout Springfield, another lender happily doing that for a borrower), the new law would effectively remove the existing six rollover limit.

While the bill is presented as a way to reform the current payday loan laws and protect the consumer, it does neither. Instead, it gives this predatory industry what it wants - free rein to rake in outrageous profits.

Consider this: In 2012, there were 934 licensed payday loan lenders in Missouri, with a cap that is among the highest in the country. They made 2.34 million loans (in a state with about 6 million people), with an average value of $306 and an average interest rate of 455 percent. This industry has every reason to protect its multibillion-dollar income.

The payday loan industry has been uncharacteristically quiet about this effort at “reform.” But it has not ignored all such efforts. In fact, in 2012 the industry spent $2 million to fight a successful grass-roots petition drive that would have put true reform on the ballot. Missourians for Responsible Lending collected more than 350,000 signatures for a ballot referendum that would have asked voters to put a 36 percent annual interest rate on the loans. That is the same cap the Military Lending Act imposes on payday, auto, tax-refund and other short-term loans made to members of the armed forces.

The industry - using such misleading names as Missourians for Equal Credit and Stand Up Missouri - cried foul, claiming such a law would destroy their lending business and prevent people who genuinely need a small, short-term loan from receiving one.

With billions in profits on the line, they were ready to spend what it took to stop an effort that was gaining widespread support among voters throughout the state. They succeeded by dragging the petitions through court until the $600,000 raised by Missourians for Responsible Lending was spent and time had run out.

MRL is ready to try again. The group’s initiative petition has been approved, and signatures will soon be collected.

Expect those friendly loan sharks to once again spend whatever it takes to stop them. It will likely be more than it took to get a friendly bill passed in the Senate that would actually make real reform more difficult.

The House, however, can stop this. Our representatives should refuse to be part of this subterfuge.

Instead, the legislature should consider outlawing or strictly regulating payday loans as 11 other states have done.


Jefferson City News Tribune, March 2

Unnecessary tampering with term limits:

Missouri lawmakers again are tampering with term limits.

If Sir Isaac Newton had been a political scientist instead of a physicist, his first law may have been a lawmaker in office tends to stay in office until removed by an outside force.

The outside force can be voters, in an election, or term limits.

In Missouri, a constitutional amendment was approved by voters in 1992 to limit total service in the House to eight years and total service in the Senate to eight years, with total legislative service limited to 16 years. Service prior to the amendment’s effective date was not included in the calculations.

Prior to the amendment, dating to Missouri’s admission into the Union in 1821, lawmakers were not subject to term limits.

We did not support the imposition of term limits for lawmakers. Although we acknowledge the advantage of incumbents, we favor the power of voters to end legislative terms at regular election cycles.

We do, however, support the will of the voters, who amended the constitution and adopted term limits.

Thus far, including during this session, we have heard no new arguments that weren’t advanced by term limit opponents in 1992.

Those arguments include: lawmakers face a steep learning curve before they become effective; limits could abruptly terminate efforts on behalf of constituents; and limits will deplete institutional memory and knowledge in the Legislature.

The institutional memory argument is the strongest, but it has not proved particularly problematic.

Among new proposals this session are bills to: expand the overall limit to 24 years; remove the designated limits in each chamber; alter the length of terms; and revise the offices decided in an election cycle.

None of these proposals is necessary.

No evidence suggests circumstances or the intent of voters have changed since 1992.

Lawmakers’ self-absorption with self-serving issues is among the reasons voters adopted term limits in the first place.


St. Joseph News-Press, March 1

Don’t mess with success:

Few extensions of government garner great respect these days, much less a resounding endorsement. Not so with our nationally recognized Missouri Department of Conservation.

The agency responsible for managing our forest, fish and wildlife resources consistently earns high marks from the state’s residents - including a 72 percent approval rating of good or excellent in a 2009 Gallup poll.

And yet, the current session of the General Assembly is rife with legislation that would be harmful to the appointed governing board, the Missouri Conservation Commission, and the work it does in partnership with the department’s professional staff.

The proposals include one that would double the size of the commission to eight members and require a representative from each of the agency’s eight regions.

This idea is advanced by a lawmaker concerned northeast Missouri is slighted by not having a representative on the four-member commission. But we have heard nothing to suggest this deficit has impaired the promotion of conservation and sporting activities in the northeast region.

Further, requiring representatives by region runs the risk of creating partisan divides where none exist now. The existing commission - the one that has served the state so well - is constituted as one that serves statewide interests.

Two other proposals would make regulations set by all state agencies, including the commission, subject to review, amendment and rejection by legislators. It’s hard to say what’s appropriate for other agencies, but this is a terrible idea for an agency such as Conservation.

“I don’t see how the Department of Conservation could operate efficiently,” well-known conservationist Anita Gorman of Kansas City recently told The Kansas City Star.

Ms. Gorman, who served 12 years as an appointed commissioner, notes what true sports enthusiasts understand all too well: fish and game regulations can change yearly, and yet each goes through a significant and time-consuming review process.

Requiring legislative oversight “could delay things greatly,” Ms. Gorman says, which is problematic when the next sporting season is just ahead.


St. Louis Post-Dispatch, Feb. 27

Coverage for new forms of cancer treatment:

Health insurance providers in Missouri have been ducking their obligations to pay for new forms of cancer treatment, those that involve pills and liquid ingestion instead of intravenous drugs. Now there’s an actuarial study, doctor and hospital support and plenty of testimony from patients that should convince the Missouri Legislature to require that providers must cover oral cancer treatments.

If that’s not enough, how about the fact that 27 states and the District of Columbia have enacted laws to ensure that patients have access to oral anticancer therapies?

Oh, best of all for this Legislature, it has nothing to do with Obamacare.

The main argument from insurance providers is that oral chemotherapy coverage will cause premiums to rise. They’ve also called it a coverage “mandate,” like that’s a bad thing. The legislation’s chief backer in Missouri, Rep. Sheila Solon, R-Blue Springs, won’t hear that.

“Every time they would say the word ‘mandate,’ the word ‘parity’ would come out of my mouth,” Ms. Solon said. “It is not a mandate. This legislation would not order coverage for anything that insurers are not already covering. It just provides coverage for it in a pill rather than through a needle.”

As to the argument about higher premiums, there is significant evidence debunking the industry’s cost estimates. In 25 of the 27 states that provide coverage, there was no impact on the insurers’ cost, said Debbie Kersting, executive director of The Leukemia & Lymphoma Society-Gateway Chapter. She added that in the two states where premiums rose - Washington and Connecticut - they went up an average of 16 cents a month per premium.

At the outside, Missouri health insurance premiums would rise an average of 57 cents a month if a law were enacted to require equal coverage for oral chemotherapy, according to an actuarial study by Lewis and Ellis Inc. of Overland Park, Kan.

One need only look back at the effort to have autism treatment be included in insurance coverage to be reminded of how much the industry inflates its estimates of the financial impact of new kinds of coverage. When bills were moving through the Legislature to try to get coverage for autism treatment, the insurance industry claimed the requirement would boost premiums up to 3 percent.

The legislation was approved in 2010, and 3,000 Missourians now have health insurance that covers treatment for their autism. The cost of that treatment is nowhere near what the industry had predicted. A new study by the Missouri Department of Insurance, Financial Institutions & Professional Registration shows that the impact on overall claims cost last year was 0.2 percent.

Oral cancer drugs are not a new treatment, but the same treatment that is currently covered but in a different form. The reason for the industry whining is a reimbursement system that covers IV chemotherapy as a medical benefit but oral chemotherapy as a pharmaceutical benefit. That sort of coverage is far less generous, with some plans capping drug benefits at $5,000 annually.

Cancer pills can be expensive, with annual price tags that can exceed $75,000. Most cancer patients can’t afford that so, without insurance coverage for the treatment, they resort to IV chemotherapy.

That treatment, which is covered by Medicare and private insurance, has some costs that exceed the treatment itself, such as implanting a port to convey the drugs, and the loss of jobs as people have to take off time from work to spend hours hooked to an infusion machine.

A bill recently approved by the Missouri Senate bars health insurers from requiring higher co-pays and deductibles for oral chemotherapy than for IV treatments and caps the patient out-of-pocket cost at $75 per prescription.

It also would prohibit insurers from increasing the cost to patients of IV chemotherapy so that it would be equal to the higher cost of oral chemotherapy.

Ms. Solon said this was the first time in three years that representatives of the insurance industry have not testified against such legislation. She takes that as the industry’s tacit acknowledgement that change is coming and that they’re going to try to manage what form that takes, rather than continue to resist.

David Smith, a lobbyist for Anthem Blue Cross Blue Shield of Missouri, did not testify against the bill but said the legislation could be changed to lower the cost to insurers and noted that a Kansas law doesn’t have the prohibition on raising the cost of IV chemotherapy.

Oral cancer treatment is for many cases the new best-practice for treating the disease, say supporters of the legislation. Ms. Kersting said 35 percent of all new cancer treatments are being released in pill form only.

Medical studies show the pills target cancerous cells more effectively than broader intravenous chemotherapy and have fewer side effects, including typical problems like fatigue, nausea and hair loss.

Cancer is a common enemy. It is neither Republican nor Democrat. Making it easier for patients to stay home while taking medicine that is more targeted for their needs just makes sense. It’s time for lawmakers to listen to the people.

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