House endorses cuts to Medicaid program

JEFFERSON CITY, Mo. -- Several thousand adults and children could lose health care coverage under legislation approved Wednesday by the House as a way to slow the growth of Missouri's multibillion-dollar Medicaid program.

The Republican-backed plan would make it more difficult for some people to qualify for Medicaid and impose new co-payments on participants each time they visit a doctor.

The legislation also would authorize the elimination of some Medicaid services not required by the federal government, such as dental and optical care for low-income adults.

In a highly unusual move, the House gave the bill initial and final approval all on Wednesday. Bills typically wait a day after they win first-round approval before the final vote is taken, but House Republicans rushed the bill through about three hours after the first vote.

The House voted 88-72 to approve the bill on a strictly partisan vote. All Republicans in attendance supported it, and all attending Democrats opposed it. The bill now advances to the Senate.

The bill would make the requisite changes in state law to accommodate some of the Medicaid funding cuts proposed in the annual state budget that takes effect July 1.

That budget plan, pending in a House committee, would shave about $110 million in state and federal money from the $4.2 billion Medicaid program, which covers about 950,000 poor, elderly and disabled Missourians.

Rep. Jodi Stefanick, sponsor of the authorizing legislation, said Medicaid has grown from 4 percent of the state budget in 1968 to 23 percent of the budget now. About 140 new Medicaid recipients are enrolled each day, she said.

One in five on Medicaid

"This program has grown so much that today, just about one in five Missourians are on Medicaid," said Stefanick, R-Ballwin. The legislation "works to protect our highest priorities, such as education, by containing welfare spending."

House and Senate Democrats said the cuts would force low-income, working families to seek medical care in hospital emergency rooms if they are no longer on Medicaid. Ultimately, that could cost the state more, they said.

"Republican leaders are choking to death every social program created in the last 50 years," Senate Minority Leader Ken Jacob, of Columbia, said at a news conference with Democratic colleagues.

During House debate, Rep. Sue Schoemehl, D-St. Louis, read a letter from Catholic bishops to lawmakers urging them not to cut health care for the poor. Immediately afterward, Republicans voted to shut off debate and then approved the bill.

Some of the bill's measures were recommended by Democratic Gov. Bob Holden, including the 50 cent-to-$3 co-payment for Medicaid recipients' doctor visits. That is projected to save $22 million in federal and state funds.

Holden also recommended another provision in the bill: a $25,000 asset limit, excluding such things as homes and vehicles, for participants in the Mc+ for Kids program. That program provides health care to children whose families lack private insurance but don't qualify for traditional Medicaid. It currently covers people with a net worth of $250,000.

The change is expected to save $800,000 in federal and state money, resulting in a loss of coverage to about 880 children.

Similar budget cuts have been tried in previous years but rejected by courts because lawmakers had not changed the state law requiring the services.

A separate budget proposal -- not needing legislative authorization -- would reduce Medicaid's income eligibility threshold for low-income parents, saving $48 million while phasing out coverage for 39,000 people.

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Medicaid bill is HB1566.

On the Net:

Missouri Legislature: http://www.moga.state.mo.us