GAW: HEALTH CARE COSTS MAY INCREASE AFTER HOUSE MEASURE

Managed health care could cost a little more as a result of legislation that overwhelmingly won first-round approval in the House Thursday.

But the legislation was needed to protect consumers, Missouri House Speaker Steve Gaw, D-Moberly, said Friday.

He said health insurance costs likely would have increased some regardless of what the legislature did.

Gaw and Majority Floor Leader Gracia Backer, D-New Bloomfield, discussed legislative issues with reporters during a stop at the Cape Girardeau Regional Airport.

They were scheduled to travel to Dexter Friday night for a reception.

Managed health care has meant major cost savings for businesses and consumers. But there have been problems too, Gaw said.

In some cases, health insurance companies didn't consider a broken bone to be an emergency and doctors were prohibited from discussing costly treatment options with patients.

The House bill would require health maintenance organizations to cover emergency room visits if in the opinion of a prudent layperson, urgent care was needed.

It also would allow doctors to speak openly about all care options and make it easier for consumers to see specialists.

Gaw gave high marks to lawmakers. "We've had a pretty good session," he said.

The House has tackled everything from pay raises to managed health care. It also approved a tax cut on food sales.

State lawmakers likely won't gamble with Missouri's casino law.

The legislature likely won't remove the restriction that prohibits a person from gambling away more than $500 per two-hour cruise, Gaw said.

The Moberly Democrat said most lawmakers feel that any effort to remove the loss limit should be left up to the voters.

While the House rejected a pay raise, it might still approve a Senate bill that would raise the daily expense allowance from $35 to $86, Gaw said.

"The per diem is something I think we ought to look at adjusting," he said. "It really is too low."

But the House speaker said he and other lawmakers aren't sure they can legally raise the per diem apart from the whole pay raise plan that was recommended by the state's pay commission.

Gaw said a 3-cent cut in the sales tax on food would provide tax relief beginning in July, if it becomes law.

Gaw said the tax cut is needed because the state has exceeded its constitutional revenue limit since fiscal 1995.

The House still has to deal with welfare reform.

But Gaw and Backer said the state already took a giant step to address the issue when it passed a law two years ago that allows a person to be on welfare for a maximum of 24 months.

Since then, 54,000 people have moved from welfare to work. "It is truly temporary assistance now," Gaw said.

Gaw and Backer said the state needs to make other changes to help get people off welfare.

One bill would authorize a state income tax credit for businesses who offer child-care services for their employees.

Backer said the state can't expect a mother of three young children to go to work for $5 an hour without some day-care assistance.

Another measure would establish a not-for-profit corporation to pool health insurance coverage for the 175,000 Missouri children who aren't covered by either Medicaid or private health plans.

Many welfare changes are being mandated by Congress.

With the reduced role of both the state and federal governments in the area of welfare, the private sector must help, Backer said.

Both Backer and Gaw criticized the Missouri Supreme Court's decision that strips a joint House-Senate committee of oversight on the administrative rules of state agencies.

The high court said it was unconstitutional. But Gaw and Backer said that without legislative oversight, there is no check on the rule-making power of state bureaucrats.

Gaw and Backer said lawmakers are considering legislative changes that would return some rule-making control to the Missouri General Assembly.

One possibility, said Gaw, is to put sunset provisions on most government rules so that they expire after a period of time unless reauthorized by the legislature.