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Mo. Sen. Medicaid Interim Cmte. Adopts Recommendations That Don't Include Expansion

Marshall Griffin/St. Louis Public Radio
The Mo. Senate Interim Committee on Medicaid Transformation and Reform meets on Nov. 13, 2013.

A Missouri Senate interim committee examining the state's Medicaid system voted this afternoon to adopt a draft report that recommends using managed care companies to provide health coverage to more of Missouri's working poor.

The report also deliberately excludes recommendations to expand Medicaid.  StateSenator and committee chair Gary Romine (R, Farmington) maintained that Medicaid must be reformed first.

"If we get this accomplished, then any other legislation that's presented will have a better fighting chance to be dealt with," Romine said.  "But until we reform and transform the current Medicaid program, no one's in a position that they feel confident in expanding anything to any additional eligibility."

The draft report's primary recommendation is to move parents, pregnant women, and children from Medicaid into managed care systems.  Other recommendations include an $8 co-pay for some patients who use ER services for non-emergencies, and providing dental coverage to adults on Medicaid.

The committee's three Democratic members, Jamilah Nasheed of St. Louis, Joseph Keaveny of St. Louis, and Paul LeVota of Independence walked out of the meeting after the Republican majority was unwilling to include expansion of Medicaid in its list of recommendations for reform.  They later returned with a proposed addendum, saying if it were included in the committee's report that they would vote in favor of it.  The first item in the addendum asked that the report reflect that the majority of public testimony received urged expansion of Medicaid. 

"We can leave out of here today with a bipartisan effort," Nasheed said.  "This is the day to show Missourians that we can come together and we can agree, and (that) we can agree without being disagreeable."

A motion to include the proposed addendum failed along party lines, after which Nasheed and LeVota left the meeting again.  Keaveny stayed behind and cast the Democrats' lone "no" vote on the Republican-led committee's draft report.

Romine later told reporters that he's willing to discuss Medicaid expansion, but reiterated that the system must first be reformed before any expansion can be considered.

Follow Marshall Griffin on Twitter:  @MarshallGReport

Marshal was a political reporter for St. Louis Public Radio until 2018.