Democrat's health-care plan would restore cuts

COLUMBIA, Mo. -- Democratic gubernatorial candidate Jay Nixon renewed his pledge to reverse Missouri's health-care cuts to the poor Tuesday while proposing to make government-run health care available to children from middle-class families.

Nixon declared: "Missouri's health-care system is broken." The main culprits, he said, are the Medicaid cuts made in 2005 by Republican Gov. Matt Blunt and the Republican-led legislature.

At its core, Nixon's health-care package would restore Medicaid to an estimated 100,000 low-income adults eliminated from the rolls and reverse the benefit reductions made to an additional 300,000.

For the first time Tuesday, Nixon also fleshed out details to expand health care beyond that. Chiefly, he proposed to allow families earning more than three times the federal poverty level -- or $63,600 for a family of four -- to buy coverage for their children through the State Children's Health Insurance Program.

That program already covers children whose families earn less than that but lack private insurance and don't qualify for traditional Medicaid coverage.

Nixon said his health-care package would cost $265 million in state funds and nearly $700 million annually in federal dollars. All this could be accomplished by tapping into existing state revenue and achieving greater efficiencies in state government, he said.

"To get this done, we won't need to raise taxes," Nixon said. "We will need to make health care a priority again in this state."

Blunt, who is not seeking re-election this year, has said the Medicaid cuts were necessary to balance the budget. A spokesman said Tuesday that the Medicaid cuts accounted for less than half the spending reductions made to the core budgets of state programs in 2005.

Nixon's potential Republican gubernatorial opponents scoffed at his health care plan.

In a debate Tuesday on St. Louis radio station KMOX, both U.S. Rep. Kenny Hulshof and State Treasurer Sarah Steelman defended Blunt's decision to cut Medicaid in 2005 as necessary to balance the state budget and suggested Nixon's plan would end up costing taxpayers.

"There's no way Nixon's proposal can be done without a tax increase, and I do not support raising taxes," Steelman said.

Hulshof suggested that reversing the Medicaid cuts would cost closer to $350 million in state funds, plus additional federal dollars, and said he would prefer free-market incentives to expand health insurance such as tax credits to small businesses.

"Jay Nixon wants to take us back to the old days, when that government-run health-care system wasn't providing that good of a service to those patients who were on it," Hulshof said.

Hulshof and Steelman both supported the concept behind Blunt's Insure Missouri plan, which would have expanded government-subsidized health care to low-income workers without restoring all of the 2005 cuts. That plan failed in the legislature this year, partly because of opposition from some House Republicans.

Nixon also proposed Tuesday to create a "Show-Me Health Care" consumer Web page allowing people to compare prices and private-sector insurance plans; to convene an "E-Health Blue Ribbon Commission" to modernize the health-care delivery system; and to focus on preventive health care.

In the year following the 2005 Medicaid cuts, the U.S. Census Bureau said the number of Missourians without health insurance grew by an estimated 104,000 to a total of 772,000 -- a spike three times the national growth rate.

Nixon cited that statistic Tuesday on his health care campaign swing from St. Louis to Columbia to Kansas City. He also presented patients and medical professionals to testify about harm caused by the 2005 cuts.

Amy Ewalt, a single mother from Fulton who also is caring for her own mother, said she lost her Medicaid benefits in 2005 and has not received health insurance from either of her two employers. As a result, Ewalt said, she cannot afford preventive health care services to guard against a recurrence of breast cancer and had to weigh the potential costs and benefits when she recently went to the emergency room with chest pains.

Fayette family physician Hope Tinker said some of her patients formerly covered by Medicaid also are delaying their doctors' visits -- especially for preventive care -- because they can't afford the out-of-pocket expense.

"The Blunt 2005 Medicaid cuts took a bad situation and made it worse," she said.

Lauri Tanner, president and chief executive of Ranken Jordan pediatric hospital in St. Louis, said the hospital serves children with special and often costly needs. The average stay is 30 days.

"We have been increasingly dependent on donors to bridge the funding gap since the 2005 budget cuts," Tanner said at Nixon's news conference in St. Louis. "Jay's plan moves our health care system in the right direction. The bottom line: It takes care of our children."

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Associated Press correspondent Jim Salter contributed to this report from St. Louis.