Senate passes Medicaid cuts proposed by Blunt

JEFFERSON CITY, Mo. -- After impassioned debate, senators passed legislation Thursday that would authorize many of Gov. Matt Blunt's proposed Medicaid cuts and end the program altogether if lawmakers don't devise an alternative within three years.

The Senate's 20-11 vote sends the bill to the House, which is expected to take it up after lawmakers return March 29 from their annual spring break. Senators had given the bill preliminary approval earlier this week after more than 17 hours of debate.

Democrats spoke passionately against the bill again Thursday, with Senate Minority Leader Maida Coleman chiding Republicans by referencing a scriptural passage from Isaiah about those who pass unjust laws that deprive the poor.

"How can you claim you are a child of God," said Coleman, D-St. Louis, "and yet you take away from those who least deserve it?"

Republicans countered with their own version of compassion, claiming government programs such as Medicaid essentially trap poor people in a cycle of dependency and provide an excuse for the wealthier not to personally help.

Doubled enrollees

"We have to rethink as a society how we handle the poor," said Senate Majority Leader Charlie Shields, R-St. Joseph.

Missouri's Medicaid health-care program has doubled its enrollees in the past dozen years and nearly tripled in cost to more than $5 billion. Blunt and fellow Republicans contend the state must scale back the program in order to provide funding increases to schools and balance the budget without tax increases.

The legislation would end the current Medicaid program by mid-2008 but create a legislative committee to recommend a revamped health-care program by the end of this year.

Blunt's budget proposal would eliminate coverage for about 100,000 of the 1 million Missourians on Medicaid by tightening eligibility standards for low-income parents, the elderly and the disabled, and by requiring annual eligibility reviews.

The bill provides the legal authorization to make some of those cuts; the other portion can simply be done through the budget.

The legislation also requires more Medicaid patients to make copayments for each doctor and hospital visit and requires premiums of more families in the Mc+ for Kids program, which provides health care to children whose families earn too much to qualify for traditional Medicaid.

Additionally, the bill repeals mandatory Medicaid coverage of such things as optical and dental care, hearing aids, wheelchairs and artificial limbs. Blunt has proposed to eliminate those services for all adults except the pregnant and blind, but a House appropriations committee has recommended continued coverage of some of those services.