MFH questions

A good question has been raised by a bill proposed by state Rep. Nathan Cooper of Cape Girardeau. At issue is the $1 billion-plus in assets managed by the Missouri Foundation for Health. Is the foundation a private not-for-profit agency or a state agency that currently has no oversight except for the appointment of an advisory board by the attorney general?

MFH was created in 2000 to settle a lawsuit Attorney General Jay Nixon brought against Blue Cross-Blue Shield of Missouri after the not-for-profit corporation shifted its assets into a for-profit insurance company. Nixon maintained the BC-BS assets belonged to residents of the 84 eastern Missouri counties served by BC-BS over the decades it had operated as a not-for-profit corporation. Nixon set up the foundation, wrote its mission statement and hand-picked board members. The attorney general continues to select the committee members who, in turn, choose the foundation's advisory board. That board determines how the foundation's assets will be distributed. Last year, MFH gave more than $50 million dollars to a variety of health-related agencies.

Nixon contends Cooper's bill is way off base. He says MFH is still a not-for-profit charity and, therefore, not a candidate for becoming part of state government, including having its board appointed by the governor and confirmed by the Senate.

Missouri's recent budget woes are well-documented. Even with a better economy, the state is struggling to make ends meet. Gov. Matt Blunt's new administration has been roundly criticized for proposed cuts in, among other things, funding for health programs.

With more than $1 billion in assets, MFH could go a long way in offsetting some of those cuts. But its advisory board isn't required to even consider the state's budgeting limitations in making its allocations.

MFH has been a strange animal from its inception. Why the attorney general was able to set up and continue to control the advisory board of the foundation has never been fully explained. His argument that MFH is a charity like United Way or Red Cross falters, because those charities don't have their boards controlled by an elected state official, nor are they subject to the state's open meetings-open records law, which the foundation is required to be under the charter written by Nixon.

All of this raises serious questions. Should the foundation be controlled by the attorney general or the governor? Should its board answer to the governor? Is there a way to better coordinate MFH spending and state budget needs?

Cooper's bill is the springboard for finding answers.