Medicaid review

Just a couple of years ago, Missouri faced a budget squeeze for state government. Demands for spending far outweighed state revenue. The budget deficit in 2005 was expected to be $300 million. In an effort to balance the budget while continuing to provide health care through Missouri's Medicaid program, the state legislature -- like many other states that year -- made major changes that eliminated some aid recipients. The changes were described at the time as necessary to protect future state budgets.

From a budgeting perspective, the plan worked. Missouri's budget was balanced. But a large number of former recipients of Medicaid aid pushed to have their benefits restored. In the meantime, the state's economy improved significantly, and this year Missouri is expected to have a $500 million budget surplus.

State Sen. Maida Coleman, a Democratic leader from St. Louis and formerly from Southeast Missouri, proposed an amendment that would have restored benefits to all Medicaid recipients removed from the program dating back to 2002. In a 16-18 vote that included support from three Republicans, the amendment failed.

The Republicans who voted for the amendment to restore benefits were all from Southeast Missouri: Jason Crowell of Cape Girardeau, Kevin Engler of Farmington and Rob Mayer of Dexter. Engler and Mayer had voted against the 2005 plan that reduced the number of Medicaid recipients. Crowell was chairman of the legislative committee that initiated the cost-cutting legislation.

Crowell says the cuts were necessary in 2005, but with a budget surplus the state can afford to provide more care to a larger number of needy Missourians. He also says he supports the MO HealthNet program, Gov. Matt Blunt's proposed makeover of the Medicaid program.

The long-term viability of providing health care to those most in need depends on a program that is consistent rather than deciding from year to year who should be covered. The future of state revenue is never certain. Any additions to Medicaid rolls should be based on prudent reviews rather than blanket reinstatement of all recipients who were once covered.