Crowell's plan would be better if it combined state plans and Medicaid programs

By Sharon Feltman

State Sen. Jason Crowell, R-Cape Girardeau, is proposing drastic changes to Missouri's health-care delivery system. His plan for a state trust fund for Missourians is a good beginning.

For years, legislators have tried unsuccessfully to do the most efficient, cost-effective thing: combine the state's fragmented, self-funded plans into one plan, saving taxpaying policyholders millions in redundant administrative costs.

The flaw in Crowell's plan is associated health plans. They don't work, because there is no mechanism to keep the association together. The private insurance industry can and does cherry pick businesses with low utilization of health care services. When this happens, the associations become dumping grounds for people who need more health care and are less profitable for the insurance industry.

The Missouri Association for Social Welfare Health Access Project has a better plan: Missouri Health Coverage Assurance.

Our plan begins by doing what Senator Crowell suggests: combine the self-funded state plans of the state universities, the Department of Conservation, Missouri Department of Transportation and the state employee plan. To create real efficiencies, the nearly 1 million Missouri Medicaid enrollees and the $6.6 billion in combined state and federal Medicaid funding should be added to the pool. This would increase the funding, the risk pool and the bargaining power for prescription drugs, the primary driver of the exorbitant increases we continue to see in our health-care costs.

With this large pool of people, we could allow individuals and business owners to buy in at an annual premium based on their income-tax return.

This plan eliminates redundant administrative costs for multiple state self-funded insurance plans, gives the uninsured in Missouri affordable insurance coverage, eliminates expensive emergency room use for primary care, eliminates uncompensated care costs for providers and eliminates the problems people with Medicaid coverage or no coverage have finding providers.

The Missouri Health Coverage Assurance plan is a fair, affordable, commonsense approach to health-insurance coverage for the people of Missouri.

Senator Crowell should look beyond the insurance industry-driven associated health plans and focus on the real needs of his constituents.

Sharon Feltman is the director of the Health Access Project Missouri Association for Social Welfare in Jefferson City, Mo.