House votes to restore program for disabled

JEFFERSON CITY, Mo. -- The House gave first-round approval Wednesday to legislation restoring a slimmed-down version of a state health-care program for the working disabled that was eliminated as part of last year's Medicaid cuts.

The restarted Medical Assistance for Workers with Disabilities program, or MAWD, would serve more than 3,100 people at a first-year cost of $16.3 million in state and federal funds. That's far shy of the $250 million program that served about 17,000 people before being eliminated.

The new program would need to be renewed after three years and would only provide benefits if the legislature appropriated money for it.

The bill needs another House vote before it can move to the Senate.

The proposal has been endorsed by a joint Senate and House committee created to recommend an overhaul of the state Medicaid program, and House Speaker Rod Jetton has said developing a new program for the working disabled is one of his priorities for the session.

Rep. Charles Portwood, the bill's sponsor, said MAWD had grown out of control since its creation in 2001, when it was projected to cover 440 people at a cost of $7 million. The best course was to eliminate it and start over, he said.

"Last year, we looked at welfare programs funded by the taxpayers that were quite literally collapsing under their own weight," Portwood, R-Ballwin, said.

But Rep. Judy Baker, D-Columbia, said Portwood's legislation doesn't go far enough by restoring less than 10 percent of the expenditures in the former program.

"We can and should do more to restore integrity to Missouri's disabled workers," Baker said.

Gov. Matt Blunt said lawmakers shouldn't create a new program that costs more than $6 million in state revenues. Financial projections show Portwood's bill costing $6.3 million in state money the first year, with the rest coming from federal funds.

"We don't want to set up a program we can't afford," Blunt said.

The MAWD program drew criticism last year because some people enrolled in the program were only working an hour or two a month.

But after the program was eliminated, lawmakers heard complaints that their action hurt some hardworking employees, particularly those at sheltered workshops that employ about 7,250 mentally disabled people to perform basic tasks at less than minimum wage.

The new program would cover people who earn less than 250 percent of the federal poverty level, which is $24,500 for an individual, and charge a 7.5 percent premium for people who earn more than 100 percent of the poverty level, or $9,800 for an individual. Earnings from a job with a sheltered workshop would not be counted toward the limits.

Democrats attempted to drop the premiums to 4 percent but were rebuffed after some lawmakers objected to adding an additional $780,000 to the cost.

Rep. Maria Chapelle-Nadal said that would be a small price to help those who were affected by last year's Medicaid changes.

"If we're able to help seniors and people with disabilities, what are we going to do with that money?" said Chapelle-Nadal, D-University City. "Are we going to continue to break the backs of our seniors and disabled people?"

Portwood said such arguments were what led to the program ballooning and becoming unaffordable, forcing the state to scrap the program.

"It was only $780,000, then only $1.2 million, then only $500,000, and at the end of the day, it was a quarter of a billion dollars," he said. "And I just can't go back down that road."

Democrats attached amendments that would raise caps on medical and independent living accounts from $2,500 to $5,000. The accounts can be used for medical care and things such as wheelchair ramps needed to get to someone's front door. Because the individual is responsible for saving the money, increasing the maximum level does not affect the cost of the proposal.