Representatives from St. Louis-area hospitals and clinics think new changes to Medicaid will lead to issues for patients, even those who don’t rely on the government-sponsored health insurance.
Around two dozen people from the health and community organizations aired concerns Wednesday at a roundtable in downtown St. Louis convened by U.S. Rep. Wesley Bell, D-St. Louis County.
The Congressional Budget Office estimates changes to Medicaid included in the newly signed federal spending and tax cuts bill mean work requirements and other changes to Medicaid could result in more than 10 million people losing coverage nationwide.
The participants told Bell that fewer people on Medicaid will result in fewer reimbursement dollars for services the organizations provide. That could lead to higher insurance premiums and other costs that will be passed on to patients.
”We see a large number of people that are underserved, underinsured and uninsured,” said Danielle McPherson, vice president of Medicaid managed care organizations and state government programs at Mercy. “That category is under attack financially. We have to make up the shortfall in some kind of way.”
Approximately 1 in 5 Missourians is insured by Missouri’s Medicaid program, Mo HealthNet.
“I think it's shortsighted of us to only think that this is only going to affect these people that are vulnerable,” McPherson said.
In addition to imposing the work requirement rule, the new bill puts a cap on a tax that helps pay for the state’s share of its Medicaid program.
President Donald Trump said the changes were needed to eliminate waste, fraud and abuse in the system.
Missouri’s senators, both Republicans, voted for the bill’s passage, though Sen. Josh Hawley expressed reservations. Dozens of state lawmakers also encouraged Hawley and fellow Sen. Eric Schmitt to sign the legislation, known as the “One Big Beautiful Bill.”
Ellie Harmon, St. Louis Children’s Hospital director of government relations, said the recently passed bill could inadvertently mean children lose insurance coverage.
“What we’ve seen is when parents lose coverage, kids often do as well,” she said. “Because logic would follow that if the parents in a family aren't eligible for the Medicaid program, they would think that their kids aren't, either.”
But Harmon said that’s not the case: Medicaid usually will cover children even if their parents become ineligible because of work requirements or income thresholds.
However, many parents will not re-enroll their kids in the program or will delay their care if they don’t know they’re still qualified for the program. That’s particularly true as funding dries up for designated “navigators” who help people sign up for Medicaid and explain how the insurance and enrollment work. (Trump administration officials have said the program is inefficient and mostly ineffective.)
“So kids will continue to have eligibility, but if their parents fall off, the likelihood of the kids falling off is much higher,” Harmon said.
Bell on Wednesday said the potential fallout should be a reminder to voters that “elections have consequences.”
“We're going to fight like hell to raise awareness, to let folks know how this impacts people from your big cities to your rural towns, and try to appeal to some of those legislators who might be on the other side of this bill,” he said.
