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Proposed Medicaid reform to affect hospitals across Missouri

January 27, 2005
By: Nicole Volhontseff
State Capital Bureau

JEFFERSON CITY - An official for Missouri's hospital industry warned Thursday that the governor's budget cuts for Medicaid could cause a problem for hospital emergency rooms across the state.

Dave Dillon, Vice President of Media Relations at the Missouri Hospital Association said the number of newly uninsured people coming to emergency rooms across the state might be a problem. He warned those without Medicaid will wait as long as possible to see a doctor.

"People will postpone their care which will compromise their health," Dillon said.

Hospitals are required to care for any patient regardless of health coverage.

Patients will absolutely be treated and no one will be turned away, said Kurt Toebben, Director of Medicaid & FRA at the Missouri Hospital Association. He added that there are plenty of hospital beds to go around, especially in the St. Louis area.

Dillon also said that the Missouri Hospital Association is planning to work with the governor through the appropriations process to stabilize Medicaid.

As for how hospitals plan to compensate for the costs of uninsured people seeking medical care, Dillon says money will not be a problem. The problem will be found when costs are shifted to employers. Those patients who are uninsured will receive payment for their bill through charity care, depending on whether or not they are eligible for the program.

Administration officials estimated that nearly 90,000 Missourians would be removed from Medicaid coverage from the budget plan Gov. Matt Blunt proposed Wednesday night.

Eligibility cuts would be extended to adults, the elderly and the disabled. Under the plan adults would have to be thirty percent under the federal poverty line as opposed to the previous seventy-five percent mark.

This would eliminate over twenty thousand adults from Medicaid pay. Sixty thousand are expected to be affected.

Those receiving Social Security Income would see their eligibility reduced from seventy-four percent to eighty percent of the federal poverty line. From that, fourteen thousand elderly individuals across the state would lose Medicaid.

Blunt plans to do away with Medical Assistance for Workers with Disabilities. The program provides coverage for employed persons with disabilities between the ages of sixteen and sixty-four. Eliminating the program will mean that a majority of people participating in the program will lose their coverage, despite being employed. Others will either be moved into another Medicaid category or to a spenddown program.

The new proposal also calls for cutting dental, podiatric, rehabilitation, and specialty services for all those receiving Medicaid. Specialty services include optical, hearing and ambulatory services.

Pregnant women, children and the visually impaired would be exempt from the proposed cuts. The governor says continuing Medicaid for these groups would be "responsible uses of taxpayer dollars."

According to the Missouri Social Services Department, in 2004 there were 974,559 people in Missouri receiving Medicaid. In some counties recipients accounted for one fourth of the population or more. The state average is about one in ten people.

Blunt's budget plan calls for a reduction of $626 million in state and federal Medicaid spending. Minus that total, Missouri's Medicaid budget will still be more than $5 billion.