Spending priorities

By Amy Blouin

Wearing rose-colored glasses makes things appear brighter than they are. So it is with Gary Rust's May 24 column ("Medical spending") that asserts Missouri's budget record for the past three years "has been good for the state." A closer look reveals a far different picture.

The column addresses the areas that received much attention in the 2007 legislative session: health care, education and tax policy.

Health care was a focal point as lawmakers passed two significant bills. MO HealthNet, the so-called Medicaid reform program, falls well short of improving access to basic, preventive health care or needed treatment.

Consider this:

• Less than 10 percent of the more than 114,000 adults and children who lost Medicaid health insurance in 2005 had their coverage restored under MO HealthNet.
• The 55,000 working parents cut from Medicaid in 2005 do not qualify for the new program. A single parent making more than $292 a month remains uninsured.
• The elderly and people with disabilities still must use their limited income to pay out-of-pocket for health care until they reach deep poverty level to qualify for MO HealthNet.
• While low-income women will receive cervical and breast screenings, should they be diagnosed with cancer their treatment will not be covered under MO HealthNet.

A health insurance bill approved this session, House Bill 818, primarily helps those who are already insured by giving them tax credits and provides expensive tax credits to insurance companies as part of the reform of Missouri's high risk insurance pool. In addition, it includes a troubling provision that allows the Department of Health and Senior Services to collect the medical debt of uninsured individuals on behalf of hospitals and other providers. This function certainly does not fall within the department's mission.

The focus of education policy this year was the sale of MOHELA assets, which could diminish the agency's ability to finance student loans, its core mission. However, the most serious education concern was not addressed: funding levels.

The inadequate school funding formula enacted in 2005 leaves K-12 public schools underfunded by $600 million. State aid to public higher education institutions was lower in fiscal year 2007 than in fiscal year 2001. While next year's budget calls for a modest funding boost, it falls well short of the level necessary to ensure Missouri's students access to an affordable college education.

Health care and education are wise investments of taxpayer dollars. An educated population, where people have access to health care, yields a positive return for the state. Economic development and a thriving economy depend on an educated and healthy work force.

Yes, these investments in health care and education require significant dollars. And, yes, efforts to improve efficiency and control costs are necessary. But cutting funding for the very services that make Missouri an attractive state in which to live and do business is extremely shortsighted.

So too is tax policy that leaves Missouri unable to adequately fund our most important priorities. In 2007, two bills passed in the legislature that together will result in an estimated $250 million in lost revenue to the state when they are fully phased in. House Bill 444 overwhelmingly benefits the wealthiest Missouri senior citizens by exempting the state tax on Social Security income.

Seventy percent of seniors do not benefit from this new law.

In addition, the legislature passed House Bill 327, which began as a relatively small adjustment to Missouri's Quality Job Act for economic development. Initially this bill had a relatively small cost to revenue of $14 million. However, in its final form it had grown to include a plethora of tax credits, increasing its fiscal impact to $96 million when fully implemented.

Missouri's economy is improving as evidenced by revenue exceeding estimates over the past two years. For fiscal year 2007, ending June 30, Missouri is projected to be in the black by about $500 million. This money could be wisely invested in services Missourians value most highly: health care and education. Yet there doesn't seem to be the will to do so.

It's time for Missouri's policy-makers to act on the highest priorities: a first-rate, fully funded education for our children and access to affordable health care for all Missourians. Perhaps next year elected officials will sharpen their vision and enact farsighted policy that adequately invests in our most important resource, Missouri's citizens.

Amy Blouin is executive director of the Missouri Budget Project in St. Louis.