Disabled advocates urge Holden to suspend Medicaid changes

JEFFERSON CITY, Mo. -- Advocates for poor, disabled residents turned in more than 3,000 petition signatures Thursday to Gov. Bob Holden asking him to suspend a budget-cutting provision that would force them to spend more of their own money before qualifying for Medicaid.

Holden has given no indication that he intends to delay the new rules, which are to take effect Oct. 1, said his spokeswoman, Mary Still.

Neither has the Department of Social Services, which oversees the Medicaid program, said spokeswoman Deb Hendricks.

Disabled Medicaid recipients plan a rally Tuesday at the Capitol. They also protested in late June as Holden signed the state budget and lobbied against the change in the Legislature.

"The governor has promised he would do something to protect the most vulnerable citizens and he hasn't," said Richard Blakley, executive director of the Disabled Citizens Alliance for Independence.

Still said the protests should be redirected toward House Republicans who blocked Holden's plan to tap into the state's so-called Rainy Day fund to supplement a tight budget and spare programs from cuts.

But it's too late to focus on the Legislature. Now "the governor's the only person in the world who can change this," Blakley said.

Missouri's Medicaid program generally covers people who earn 77 percent of the federal poverty level -- $6,645 annually for an individual or $13,635 for a family of four.

At issue are about 24,000 people covered under the so-called "spend-down" provision, which allows people to receive Medicaid if they spend enough on medication to lower their available income to eligible levels.

That determination has been made on a quarterly basis. And if a person incurs enough medical expenses in one day to qualify, the state Medicaid program historically has picked up the whole bill.

Must spend own money

The federal government recently suggested that people must spend their own money -- not just incur costs -- to qualify for Medicaid.

Partly in response to the federal concerns, lawmakers agreed to switch to a monthly qualification period and require people to spend some of their own money before Medicaid picks up the rest of their costs.

The change would make the "spend-down" provision of Medicaid similar to a private insurance deductible.

But advocates for the disabled say it would eat up so much of their monthly Social Security checks that they could no longer afford to pay personal aides and could be forced to move into nursing homes. That ultimately would cost the state more money, Blakley said.

"They looked at something they thought would save a few dollars," he said. "They didn't know the impact it would have on people's lives."

Advocates for the disabled would like the Medicaid changes delayed until the next fiscal year starts in July. That would allow time for the Legislature to raise the minimum income levels needed to be eligible for Medicaid, Blakley said.