Medicaid eligibility boosted by state Senate

JEFFERSON CITY, Mo. -- Thousands of Missourians targeted by Gov. Matt Blunt to lose their Medicaid coverage would be able to keep it under a Senate budget plan.

The budget endorsed by the Senate Appropriations Committee still would cut the government health-care program for the poor, but not as much as the budget proposed by Blunt or passed last week by the House.

The Senate budget plan is expected to be debated by the full chamber beginning Tuesday. It was finalized late Wednesday night.

To restore some proposed Medicaid cuts, the Senate budget plan makes cuts in other areas. For example, state colleges and universities would be hit with a 5 percent reduction in their state aid. The budget plans backed by Blunt and the House had kept higher education funding steady from last year.

The Senate and House versions of the budget must be reconciled by negotiators from each chamber. The constitution requires the legislature to pass a budget by May 6 -- a week before the end of its session.

When proposing a budget in January, Blunt said cuts to Medicaid were necessary to avoid a tax increase while continuing to provide more money to K-12 schools. His proposal would have eliminated Medicaid coverage for about 100,000 of the state's 1 million recipients by lowering the income levels needed to qualify.

For example, a parent of two children currently can qualify for Medicaid while earning up to 75 percent of federal poverty level, about $1,005 a month.

The budget passed by the House and backed by Blunt would cut the parent's eligibility level to about 23 percent of the poverty level -- $292 a month for a family of three. But the Senate Appropriations Committee endorsed a plan setting the eligibility level for parents at 50 percent of the poverty level -- $670 a month for that same family.

The Senate plan would result in 31,000 fewer parents being forced off Medicaid, according to projections provided Thursday by Brian Kinkade, the budget director for the Department of Social Services.

None of the various budget plans have proposed to cut Medicaid coverage for children, pregnant woman or the blind.

But the House budget plan would require families to pay more money out of pocket to participate in the MC Plus for Kids program, which covers children whose parents earn too much to qualify for traditional Medicaid but don't have private insurance.

The Department of Social Services projected that the House's proposed premiums would have resulted in 23,700 children losing coverage, because their parents would have dropped out rather than pay the premium.

The Senate committee adopted a proposal by Sen. Pat Dougherty, D-St. Louis, to institute a graduated premium plan, meaning parents with higher incomes would pay higher premiums than those with lower incomes. The plan would generate less money for the state, but the department also projects that no families would drop out as a result.

Dougherty, who has opposed most of the governor's Medicaid cuts, said he was optimistic about the Senate budget plan.

But "that's not to say it's a good budget for people who depend on health care," he said. "It still hurts too many people."

Senate Appropriations Committee chairman Chuck Gross, R-St. Charles, said his committee included money to restore as many of the proposed Medicaid cuts as it could afford to do while still balancing the budget.

Some changes were intended to provide as much bargaining room as possible with the House.

But one area with relatively slight differences between the chambers is the Medicaid eligibility level for the disabled and elderly. The House plan would set the cutoff at 80 percent of the poverty level. The Senate plan would set it at 85 percent. Under legislative rules, the final version would have to be somewhere between those two figures.

Either way, however, the budget would wipe out recent increases in eligibility levels for the disabled and elderly. Under a 2001 law that is being repealed, their eligibility level had gradually risen to 100 percent of the federal poverty level this year, which amounts to just under $800 a month for an individual.

The House plan would affect 25,390 seniors and disabled people by eliminating their coverage or requiring them to spend more of their own money to remain on Medicaid. The Senate plan would end coverage or require greater payments from 19,630 of those individuals.