Missouri Legislature Approves Bill To Revise State Medicaid Program

The Missouri Legislature on Friday approved a bill (SB 577) that would revise the state Medicaid program, the Kansas City Star reports (Wagar/Hoover, Kansas City Star, 5/18). The legislation, finalized early Friday morning in negotiations between state Rep. Rob Schaaf (R) and state Sen. Charlie Shields (R), would:

• Restore Medicaid coverage for about 4,000 workers with disabilities and 6,000 children who lost coverage because their parents had access to health insurance through their employers;
  
  
• Restore Medicaid coverage for some optional benefits, such as dental and eye care, for adults (Franck et al., St. Louis Post-Dispatch, 5/19);
  
  
• Provide cancer screenings and family planning services for about 90,000 women whose annual incomes make them ineligible for Medicaid;
  
  
• Revise SCHIP income eligibility requirements to restore coverage for about 20,000 children;
  
  
• Require state Medicaid officials to develop a proposal to increase reimbursements for health care providers to the maximum federal level within four years;
  
  
• Allow physicians to collect copayments from Medicaid beneficiaries;
  
  
• Require state Medicaid officials to assign Medicaid beneficiaries to a primary care location and enroll them in a health improvement plan;
  
  
• Establish a pilot program in one rural area and one urban area of the state that would allow workers and employers to purchase health insurance subsidized with state and federal Medicaid funds (Kansas City Star, 5/18); and
  
  
• Establish an 18-member committee that would be responsible for oversight of revisions to the state Medicaid program (St. Louis Post-Dispatch, 5/19).

Comments
Rep. Chuck Portwood (R) said, "The reforms we are making are designed to make people become more self-sufficient."

However, critics said that the bill would not restore Medicaid coverage for about 100,000 adults who lost coverage in 2005 because of revisions to income eligibility requirements. State Rep. Margaret Donnelly (D) said, "It doesn't matter how nice our new Medicaid home looks," adding, "If I don't have a key, I am still health care homeless" (St. Louis Post-Dispatch, 5/19). State Sen. Wes Shoemyer (D) said, "My people will say they're spending record amounts on health care, too, and we're not doing anything special. What in this bill fixes that? Until we do that, I don't know how I can tell my people to just get by."

State Sen. Chuck Purgason (R) criticized the provision in the bill that would restore Medicaid coverage for some optional benefits because of cost concerns. Restoration of Medicaid coverage for dental care for adults would cost the state between $12 million and $15 million annually, and restoration of eye care would cost as much as $2 million annually, the Star reports (Kansas City Star, 5/18).