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House hearing on Medicaid stretches into the night

March 30, 2005
By: Ben Welsh
State Capital Bureau

JEFFERSON CITY - One email changed Barbara French's whole day.

French, 67, of Edgar Springs, received an alert from a liberal think tank Wednesday morning that Gov. Matt Blunt's proposed cuts to Medicaid would come up in a House committee that night.

She sprang into action.

"I had to immediately get into my car and get there," said French, a mother to four mentally ill children who has volunteered for the last eight years at the National Alliance of Mentally Ill in nearby Rolla.

French was just one of dozens of protesters who filled a Capitol hearing room to capacity. The evening meeting stretched on into the night and past press time.

On the table was a bill backed by Blunt that would slash Missouri's Medicaid program.

Medicaid is a joint program between the federal and state government which provides health care the poor, elderly and disabled. It covers nearly 1 million Missourians and accounts for more than a quarter of the state's expenses.

The bill, SB 539, is a companion to Blunt's proposed budget. The governor's plan would toss an estimated 100,000 Missourians off of Medicaid rolls. Together they're part of a Republican push to overhaul a state program Blunt and other Republicans describe as out of control. They say the cuts are unavoidable without raising taxes or cutting education funding because of Missouri's budget shortfall, which estimates have placed between $600 million and $700 million.

"What we are doing will not be politically popular," said Sen. Chuck Purgason (R-Caufield), the bill's sponsor. "Our Medicaid system cannot be fixed by new funding or one time fixes."

Besides scaling back a number of services, the law would eliminate the entire Medicaid program in 2008. A commission of legislators would be charged with developing recommendations for alternatives. After that the General Assembly would then have to come up with a replacement system before the old one died out.

Opponents have called the plan cruel.

"There's a difference between overhaul and eliminating 100,000 people," said Paul Woody, spokesman for the House Democrats. "We do not believe that's how you reform a system."

The measure is designed to reduce Medicaid spending by:

>Knocking down the eligibility line. Only singles who earn less than 74 percent of the poverty level and couples who earn less than 82 percent would qualify.

>Ending the requirement that the state pay for "optional" services like wheelchairs, prosthetics, dental work and eye care. They could still be funded through appropriations but there would be no guarantees. House Republicans have come up with a way to pay some of these program in early drafts the budget.

>Eliminating the Ticket to Work program which covers 9,529 people who earn their benefits by working part-time.

>Cutting payments made to parents of adoptive parents who make more than 200 percent of the poverty level.

>Ordering an annual audit of the eligibility of all recipients, who would be required to provide proof of income or risk losing coverage.

The bill cleared a filibuster by Senate Democrats two weeks ago. It must make it through the House committee process and win a majority on the lower chamber's floor before it can be sent to the governor's desk.

Medicaid's fate will not be decided until the budget is done. Under state law, the state's expenses must be finalized by the end of the legislative session on May 6.