Mo HealthNet replaces Medicaid, but has critics

ST. CHARLES, Mo. (AP) -- Gov. Matt Blunt lauded Missouri's reshaped Medicaid program as an innovative leap forward in health care for the needy. But opponents, including several Medicaid recipients, said the program leaves hundreds of thousands with inadequate coverage, or no coverage at all.

Mo HealthNet increases choice, improves quality and promotes preventative care, Blunt said on Tuesday, the first day of the new program.

"As I said in my State of the State address, Mo Healthnet stands apart from what any other state has done or is doing," Blunt said. "It transforms Missouri's health care safety net, empowers Missourians to be participants and focuses on health, wellness and prevention."

But Laura Ahner of the Missouri Progressive Vote Coalition called it "a safety net with gaping holes" that locks out more than 100,000 Missourians eliminated from Medicaid in 2005. Ahner said it also fails to address more than 700,000 needy residents who lack health care insurance.

Mo HealthNet restores some of the cuts to thousands who lost coverage due to budget cuts two years ago. A priority of the Republican-led Legislature, it passed on the final day of the 2007 session over the objections of some Democrats, who had wanted the bill to reverse all of the 2005 Medicaid cuts.

After reducing services and tightening eligibility, Missouri's Medicaid program for the poor fell from a peak enrollment of 1 million two years ago to about 825,000.

Although widening coverage somewhat, Mo HealthNet focuses on changing the way Medicaid services are delivered. Each enrollee now will undergo a health risk assessment to try to catch problems before they become serious. By 2011, the Department of Social Services will create several health plans with varying levels of coordinated care.

By next summer, the department must also develop a four-year plan to increase payments for doctors and other Medicaid providers, an effort to entice more physicians to accept Medicaid patients.

Blunt said that in addition to providing a better quality of life, the new program will be more sustainable for taxpayers.

The bill authorizes adult Medicaid recipients to receive dental and eye care benefits, both of which were eliminated two years ago. But lawmakers included no money for the benefits in the budget, meaning they still will not be provided.

Similarly, there is no money budgeted for the bill's women's health initiative, which would provide pelvic exams, cancer screenings and family planning services to an estimated 82,500 lower-income women age 18 and older who lack employer-sponsored health insurance.

This year's budget does include money for provisions that include expanded coverage to several thousand children of lower-income parents; extended coverage for foster children up to age 21 instead of 18; and restored or improved coverage to a few thousand working disabled residents whose benefits were cut in 2005.

Several Medicaid recipients and their relatives appeared at a news conference in St. Charles put on by the Missouri Progressive Vote Coalition and spoke out against Mo HealthNet.

Donna Wilson, 64, of Foristell, said she faces high medical bills due to a kidney transplant, diabetes and other ailments. She has been told her monthly health care cost will rise to $1,600, an amount she can't afford.

"I think something needs to be done," she said.

Regina Hollrah's daughter, Cathy, suffered throughout her life from a chromosome disorder that required constant medical attention. She died in February at age 31 after 10 years on Medicaid.

"Everyone has a preconceived notion about Medicaid patients as people trying to defraud the government, and they're not," Hollrah said. "They are people who can't help who they are, who are doing their best. Let's not mix this up with people who are low-lifes who don't want to work."