This article first appeared in the St. Louis Beacon: Amidst legislative wrangling and uncertainty, the MoHealthNet Oversight Committee passed a resolution on Tuesday in support of expanding Medicaid.
The committee – which was set up in 2007 after lawmaker restructured the program – voted 8-2 with one abstention for a resolution “strongly encouraging the Missouri General Assembly and the governor to pass and sign enabling legislation in the 2013 session” expanding the program to 138 percent of the federal poverty level. That's about $26,000 a year for a family of three and $32,000 a year for a four-member family.
“The failure to enact an expansion of Medicaid eligibility, which would ensure access to improved medical-care benefits for low-income Missourians, the majority of whom are working and without access to affordable employer-sponsored insurance, will be a detriment to health, social and behavioral outcomes for these persons, as well as the economic health of their communities, limiting the economic development potential for the entire state of Missouri,” the resolution states.
The MoHealthNet Oversight Committee includes representatives from a number of state agencies, including the Department of Social Services, the Department of Health and Senior Services, the Department of Mental Health and the Department of Insurance, Financial Institutions and Professional Registration. Those heads of those agencies are appointed by Gov. Jay Nixon, a Democrat.
The committee’s members also represent hospitals, dentists, primary care physicians, consumers and patients. It also includes four state legislators, including two physicians – state Sen. Rob Schaaf, R-St. Joseph, and state Rep. Keith Frederick, R-Rolla.
Supporters of the expansion -- such as Nixon, the Missouri Hospital Association and many chambers of commerce -- say the move would be an economic boon and prevent potentially steep cuts at rural facilities. But critics, mainly Republican lawmakers, have questioned how Missouri would pay for the expansion after the federal government requires the state to pay a 10 percent share after 2016.
Timothy McBride, a member of the committee and a professor in the Brown School at Washington University in St. Louis, told the Beacon that his committee “wanted to be put on record supporting Medicaid expansion up to 138 percent of the poverty line along the lines of what was called for in the Affordable Care Act.”
“We didn’t specifically endorse a specific bill or one party’s approach,” McBride said. “But it basically said to make maximum use of the federal funds and to expand coverage to 138 percent of the poverty line. So we want to be put on record to do that.”
Nixon recently met with Republican caucuses in the House and the Senate. Both chambers have rejected in committee Nixon’s preference of expanding the program to 138 percent.
But legislation is moving through the House to make significant changes to the program, which Nixon suggested yesterday could become the vehicle to pass something this year. But both Senate President Pro Tem Tom Dempsey, R-St. Charles, and state Sen. John Lamping, R-Ladue, told the Beacon this week that the debate over the issue could stretch into 2014.
McBride said a compromise is possible.
“It seems like we could find a middle by creating some reform or transformation that would be acceptable to Republicans and expansion up to 138 percent of the poverty line, which could bring in the federal funds,” McBride said. “That was a middle ground. But it doesn’t like we’re there yet.”
