Blunt promises improved health care

JEFFERSON CITY, Mo. -- Gov. Matt Blunt promised improved health care for all Missourians on Wednesday while proposing to replace Missouri's health-care plan for the poor with "an entirely new system" unlike anything else in the United States.

Two years after reducing benefits for hundreds of thousands Medicaid recipients, Blunt anchored his State of the State address with a pledge to increase the quality of health care for the roughly 825,000 still covered by the renamed "MO HealthNet."

The Republican governor's plan also seeks to entice businesses to expand health coverage to some of Missouri's 700,000 uninsured through a mixture of state tax breaks and subsidies.

"Tonight I promise to deliver improved access to affordable health care for every Missourian and the guarantee that the sick and the poor will be well served," Blunt said to a standing ovation from majority Republicans in a nearly hourlong speech to a joint session of the House and Senate.

"What I propose with MO HealthNet is not a minor reform," Blunt said. "It is an entirely new system. It will stand apart from what any other state has done or is doing."

The revamped Medicaid program would match enrollees with a primary health-care provider and emphasize illness prevention by granting bonus health benefits to those who try to lead healthy lives. Doctors would get more money from the state to try to reverse a shortage of physicians participating in the current Medicaid program.

Democrats doubted the grand scale of Blunt's proposal -- noting it would restore government health-care coverage to only a few thousand of the roughly 175,000 Missourians who were dropped off Medicaid since shortly after Blunt took office in January 2005.

In remarks prepared for a Democratic response, Attorney General Jay Nixon said Democrats would make the restoration of Blunt's previous Medicaid cuts their No. 1 priority. He highlighted efforts by governors in Massachusetts, California, Illinois and Kansas to try to ensure all residents have health insurance.

"Governor Blunt asks how much health care he can possibly cut," said Nixon, who is running for governor in 2008. "We ask how much health care can we possibly provide with the money available."

Blunt, by contrast, said the 2005 cuts combined with efforts to eliminate wasteful spending "saved Medicaid" from a "system that was bankrupting our state."

Still, Blunt's proposed $6.4 billion Medicaid program comprises the largest portion of his proposed $21.4 billion operating budget for the state fiscal year that begins July 1.

The budget would grow by about 3 percent. But unlike most years, the governor isn't proposing to spend everything the state takes in. Blunt proposed to set aside $200 million for future years.

Blunt embraced about $133 million in proposed tax breaks, including House Speaker Rod Jetton's plan to eliminate state income taxes on all Social Security benefits. He also proposed to exempt nearly 87 percent of the state's businesses from the franchise tax, as long as they provide health care to their employees. Another proposal would allow Missouri income taxpayers to deduct the full cost -- instead of only half the cost -- of their premiums for long-term care insurance.

Blunt's budget also projects $30 million in new sales tax revenue by proposing to reverse recent Supreme Court decisions that interpreted certain telephone equipment, rental items and other machinery as exempt from the existing tax code.

Even so, Blunt declared his budget "does not raise taxes." His budget director, Larry Schepker, described the increased sales taxes as "correcting the current tax structure."

Blunt's budget proposes $2.8 billion in basic aid for K-12 public schools -- an increase of about $133 million over what was originally budgeted for the current school year. That won't be enough, however, to persuade about half of the state's 524 school districts to drop their lawsuit contending the state does not provide schools enough money nor distribute it fairly.

Public colleges and universities would get about $917 million -- an average increase of about 4.5 percent but far shy of the 12.5 percent increase recommended by the Missouri Coordinating Board for Higher Education.

Schepker said higher education officials have agreed to a governor's office plan to phase in the full requested amount over several years in exchange for new accountability measures.

Blunt proposed to cap college tuition increases at the annual rate of inflation, except in extraordinary circumstances approved by the state coordinating board.

The governor's budget also includes a 3 percent pay raise for most state employees.

Blunt proposed to make the death penalty mandatory for people who kill law enforcement officers, supported legislation that would increase competition among cable television and traditional telephone companies and backed efforts to protect people from legal liability for killing or injuring intruders at their homes.

Summing up accomplishments that he contends have strengthened Missouri's economy, Blunt declared: "Fellow Missourians, the state of our state is strong, prosperous and vibrant."

Nixon, by contrast, said Missouri is lagging the nation's job growth and asserted that Missourians' paychecks are growing by a lesser rate than residents' elsewhere.

"You are working harder, but you are not getting any further ahead. Governor Blunt is leading us in the wrong direction," Nixon said.