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Gibbons says Medicaid must go

March 16, 2005
By: Ben Welsh
State Capital Bureau

JEFFERSON CITY - The Missouri state Senator pushing a bill that would entirely eliminate the current Medicaid program by 2008 described the health care system Wednesday as spiraling out of control.

In an interview with MDN, Sen. Michael Gibbons (R-Kirkwood), promised to "move boldly forward" with a plan to reenvision the state's Medicaid program and begin again with a "clean slate."

Gibbons proposal was approved by the Senate late Tuesday night after Republicans broke a Democratic filibuster that stretched for more than 17 hours. It was attached as an amendment to the Medicaid cuts backed by Gov. Matt Blunt. The measure would create a commission that will be asked to come up with recommendations for a completely new system to replace the nearly 40 year old Medicaid program it eliminates.

"I think it's a gross injustice to allow this system to continue," Gibbons said. "This current system fails in everything it's supposed to do."

Medicaid is a joint program between the federal and state government that provides health care for the poor, elderly and disabled.

The budget proposed by Blunt during his first State of the State address earlier this year sought to knock nearly 90,000 people out of the system and eliminate many services for the elderly and disabled. House budget makers have put forward a less severe package but Republicans argue the cuts are unavoidable without raising taxes or cutting education funding because of Missouri's budget shortfall, which estimates have put at between $600 million and $700 million.

Opponents have called the cuts cruel.

"If they can come up with a plan that's better great but anytime you're losing people hurting and suffering the plan can't possibly be better," said Sen. Maida Coleman (D-St. Louis).

Gibbons described Blunt's cuts as "modest" reductions that should be seen as "pretty good news" when compared to those proposed in other states like Tennessee, where the Democratic governor has suggested totally eliminating their state's program.

"We're running out of time and we're running out of money," Gibbons said. "To me, cruelty would be letting people think they are safe and then finding out when it collapses."

The Senate bill, which has Blunt's support but must still be approved by the House, calls for a 10 person commission made up of legislators from both parties and advised by the directors of state departments related to health care. They will be charged with developing recommendations for lawmakers by September 1 of this year. The General Assembly must then come up with a new program before the old one ends in 2008.

"We cannot tinker around with the system," Gibbons said. "It's impossible to fix it. We have to start fresh."

Democrats have argued the new program should be developed before the old one is eliminated.

"The legislature has been known to put out good legislation but we are talking about programs that have been around for decades," Coleman said. The Democratic leader expressed concern that only Republican views would be heard by the commission.

Gibbons said he is "very confidant" the legislature is up to the task. He said he wants a new system in place by summer 2006, two years before it would have to take over, and promised the commission will welcome all comers.

"We will invite and be open to anybody who has any ideas about how the system should work," Gibbons said. "Regardless of where people are by party, we want to hear from everybody.

"This is not a partisan issue. This is about protecting the vulnerable people in Missouri."

Throughout the 1990s, Missouri's Medicaid rolls swelled. When the late Democratic Gov. Mel Carnahan took office in January 1993, just over 510,000 Missourians were enrolled in the system. According to the state's latest estimates, nearly 1 million are covered today. The program's $4.8 billion price tag accounts for more than 28 percent of Missouri's total budget.

Although he argued in an editorial earlier this week that too many people are on Medicaid, Gibbons said Wednesday that it was too soon tell if a new system would mean fewer recipients.

"There's no preconceived notion going into this," Gibbons said. "The hopeful and optimistic thing is that there's no agenda here other than to build a system that works for the people of Missouri.

"We need to be leaders," he said. "When this is all said and done it's my fervent hope that Missouri is a model for the rest of this country on how to deal with the problem."