The new Medicaid

When Gov. Matt Blunt took office at the start of 2005, the state's Medicaid program -- mostly for low-income Missourians who rely on the federal-state program for health care -- the system's skyrocketing expense was a financial train wreck waiting to happen.

When major Medicaid cuts were made that took benefits from 170,000 Missourians, the governor pledged an overhaul. In last week's State of the State address, Blunt gave a preview of the new plan.

MO HealthNet is, in the governor's view, a new approach to delivering health care to the 825,000 Missourians currently covered by Medicaid and to some of the 700,000 of the state's residents who are uninsured. The biggest change in the governor's plan is taking aim at preventive care instead of waiting to provide costly critical care.

To do this, MO HealthNet will have to find ways to attract more health-care providers. Clinics like the ones operated by Cross Trails Medical Center currently provide such care, but hospital emergency rooms are being overrun with patients who don't have and can't afford primary-care doctors.

Blunt is proposing a budget that calls for spending $6.4 billion on the Medicaid replacement, which would eat up well over a quarter of his proposed $21.4 billion operating budget.

Thousands of Missourians will be watching to see if Blunt's concept for what he is calling a national model really means healthier lives at an affordable cost.