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McCaskill: Elderly among those hurt by Missouri's refusal to expand Medicaid

U.S. Sen. Claire McCaskill at a hearing at Washington University with more than a dozen experts in medicine and geriatrics 3/31/15
Jo Mannies | St. Louis Public Radio

As U.S. Sen. Claire McCaskill sees it, the Missouri General Assembly will be sharing more of the blame as the state’s medical professionals find it more difficult to provide the services and funding needed to care for Missouri’s growing elderly population.

McCaskill, D-Mo., told local geriatric specialists Tuesday that the state’s refusal to expand Medicaid – as sought by the federal Affordable Care Act – will be felt particularly in nursing homes and hospitals around the state.

“These hospitals are closing, and these nursing homes are going to end up with substandard care for people who have worked hard all their lives,” she said. “It’s embarrassing, it’s shameful and it’s stupid that they will not take that money because it is somehow associated with President (Barack) Obama.”

So far, Missouri has turned down about $4 billion in federal money to cover the first two years of the proposed expansion of the program, which would have covered an additional 300,000 people. The money was supposed to replace other federal money that hospitals had been receiving for years to help cover the costs of uninsured patients. As a result, some hospitals are already laying off workers, and some in rural areas are closing down.

McCaskill said there’s no question such cuts affect the elderly and the disabled, even if they remain on the Medicaid rolls. That’s because they often are most affected by hospital cutbacks. Medicaid also is at risk, she said, because of other program cuts sought largely by Republicans now in control of Congress.

The state’s rejection of the federal money, she said, will likely lead to hospitals and nursing homes offering two tiers of care: one for the wealthy and the other for the poor who lack Medicaid coverage.

She said that Missouri officials are “being ignorant and stubborn” when it comes to Medicaid expansion, which she noted is under way in many of Missouri’s neighboring states.

In an interview afterward, McCaskill made clear her complaints weren’t directed just at Republicans. She faulted Gov. Jay Nixon, a Democrat, for failing to press for Medicaid expansion until after his re-election in 2012.

McCaskill offered her comments at a hearing at Washington University, which featured more than a dozen experts in medicine and geriatrics who discussed the issues faced by the elderly and those who care for them.

Dr. John Morris, head of the Charles F. and Joanne Knight Alzheimer's Disease Research Center, warned that the federal government’s failure to promote key medical research could have profound implications.

Referring to Alzheimer’s, Morris said, “It’s terrible and it’s going to overwhelm our society.”

McCaskill called on the professionals to do what they can to lobby Congress on the importance of federally funded research.

Some called for federal and state governments to change the Medicaid rules so that program money can be spent for assisted living, and not just for nursing home care. Assisted living usually is cheaper. Even so, given the climates in Congress and in Jefferson City, McCaskill held out little hope for any change.

Jo Mannies is a freelance journalist and former political reporter at St. Louis Public Radio.