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Senate gives final approval to Medicaid bill

March 17, 2005
By: Chris Blank
State Capital Bureau

JEFFERSON CITY - In the Senate's final debate of the first half of the session, Senate Minority Leader Maida Coleman, D-St. Louis City, questioned the Christian values of Republicans as the Senate prepared to vote on a measure to cut the size of the Medicaid program.

"I say how you can claim that you're a child of God, a Christian on this earth, a person who's here for others and yet you take away from people who lest deserve it?" she said.

The debate, which included Sen. Chuck Purgason, R-Caulfield, comparing social welfare programs to the relegation of American Indians to reservations, immediately proceeded Senate passage of a bill that would cut the Medicaid rolls.

"We've taken this reservation system put it into every city in America and gotten the same result: drugs, violence, alcoholism and no father in the home," Purgason said.

Medicaid, the state's largest welfare program with almost 1 million enrollees, is a jointly funded, state and federal welfare program that pays the health care costs of the disabled, low-income and elderly.

Legislative staff estimates indicate more than 50,000 would be removed from the rolls.

Throughout much of the debate, comments from the Democrats ranged from hinting to overtly stating that the Republican proponents were being hardhearted to the poor. Sen. John Griesheimer, R-Franklin, said those comments hit close to home for him because he was raised by his grandmother after his mother died. He said although she might have been eligible for Medicaid had the program existed, his grandmother never would have accepted the help.

"There are very few people here who have walked the shoes that I have," Griesheimer said. "I would never, ever vote for a bill that would hurt people like her--I couldn't do that."

An amendment to the bill would end the entire program in 2008, which Sen. Michael Gibbons, R-St. Louis County, said was necessary in order to spur the state forward to change the system and eliminate the people abusing the system and better help those needing help.

"We never heard any comments throughout this entire debate that this system is good," he said. "This system, I think by all accounts, is a complete, unmitigated failure."

Senate Democrats said, however, that there should be a program in place before eliminating Medicaid.

"Compassion is not defined by reforming the system and leaving a wake behind us," Sen. Pat Dougherty, D-St. Louis City, said.

Coleman said it was unfair to cut the entire program because a thorough examination of the system would allow the state to remove only the ineligible people from the system.

"If you have a problem with employees, you don't fire everyone in the building," she said. "You find the specific people who are doing wrong, and you fire them. You don't throw the baby out with the bath water."

The program has swelled throughout the 1990s, and its cost has grown to $4.8 billion and more than 28 percent of the state's budget. Republicans said the growth and comments from Senate Democrats about compassion illustrated the mind-set that spending more money was the way to help the poor.

"I got elected to this body, and I got to be even more compassionate because not only did I get to spend my own money, but I got to spend others' money as well," Sen. Charlie Shields, R-St. Joseph, said.

Sen. Kevin Engler, R-Farmington, who, along with Sen. Bob Mayer, R-Dexter, crossed party lines to vote against the bill, said he was frustrated the Democrats were stalling to reform the system. Engler said, however, that he could not support cutting benefits because of the number of people in his district on the program.

"We need to make sure we have a program that gets health care to be the people who need it rather than one that just sets up parameters and lets everyone jump on board," Engler said.

The House must act on the bill next, and House Speaker Rod Jetton, R-Marble Hill, said the Medicaid bill would be the next major issue to hit the House floor.

Across the hall from the Senate debate, Jetton, announced he had filed a bill to legislate the enrollment of Missouri in a multistate program to import prescription drugs from Canada.

Missouri has been enrolled in the I-SaveRx program by the executive order of former Gov. Bob Holden, but Jetton said it was better to permit the importation through legislation because a new governor could overturn an executive order.

Lt. Gov. Peter Kinder said he believed enrollment made sense despite objections from Washington and the Food and Drug Administration over the importation of prescription medication.

"The issue of a lack of safety of drugs coming in from other countries is a real one, not to be taken lightly, but it is not one the state of Missouri is competent to deal with," he said.

The I-SaveRx program was created in Illinois to permit citizens to buy drugs from Canadian pharmacies and includes several safety checks, which proponents said is at least as stringent as for drugs bought in the United States.

Wisconsin, Kansas and Vermont are the other states enrolled in the program.