Mending Medicaid

With changes in Medicaid eligibility adopted in Missouri this year, there were bound to be participants in the health-care assistance program who would be unclear about how the revised program would affect their benefits.

Many of these Medicaid recipients have talked to caseworkers in the state Division of Family Support Services, and many of them also have called their state legislators asking for assistance and, sometimes, specific information about their particular situation.

Because some legislators indicated the Medicaid recipients were asking for detailed assistance that they were unable to provide, and because some legislators said it appeared the Medicaid recipients were calling them because at the advice of caseworkers, a Family Support Services official put out a memo asking caseworkers not to tell clients to call their legislators.

That memo created quite a hubbub around the state. Many Missourians saw it as an attempt to keep state residents from talking to their legislators about their serious concerns.

But legislators can't handle many of the specifics of a program like Medicaid. And Family Support Services officials rightly believe caseworkers are best equipped to deal with questions created by the changes in Missouri's Medicaid system.

It would be difficult to find a state legislator who would tell constituents they shouldn't bother with their problems. Legislators make every effort to provide services to constituents.

But the Medicaid issue is much bigger than all of this (see the "Medicaid medicine" column written for the Wall Street Journal elsewhere on this page). A special commission has been asked by Gov. Matt Blunt to recommend a plan for Medicaid to replace the existing costly system, one that will continue to provide essential services to the state's most needy residents without scarfing up most of the state's budget.

Legislators will continue to be involved in major Medicaid decisions. They need to hear from Missourians about this program. And questions about specific Medicaid issues should be directed to Family Support Services.