With the Missouri legislature mired in a logjam of bills and under pressure to come up with a budget, no new legislation will see movement. Still, a proposal to expand Medicaid was filed this session.
Its sponsor, Senate Democrat Jill Schupp of Creve Coeur, says it would bring health care to hundreds of thousands of disabled people, pregnant women and low income families. She contends the current arrangement leaves far too many people in need uncovered.
“If you are a family whose income is more than $5,000 a year, family of four, you make too much money in the state of Missouri to access our state healthcare program.”
Under Schupp’s bill, eligibility for Medicaid in Missouri would be expanded to cover low income adults 18-64.
The threshold for eligibility would be raised from 19 percent of the poverty level to 138 percent when fully implemented.
The federal contribution under the expansion would be 95% in 2017, and would gradually decrease to 90% by 2020 where it would remain.
Under the state’s existing arrangement, the federal government contributes 51% of the more than $8.3 billion Medicaid outlay. Of the state’s contribution,17% comes from general revenues which the legislature allocates, while 17% is supplied by health provider fees and 15% is covered by other state funds, including pharmacy rebates.
Critics says expanding Medicaid would exponentially increase the state’s cost to a program which already absorbs nearly half of the state’s general revenues.
Republican Governor Eric Greitens, pointing to recent figures in another state, claims Medicaid expansion would be a disaster in Missouri. “When you look at states like Ohio, for example that expanded it, cost overruns of over $3 billion. It’s actually really busted those budgets.”
Supporters of expansion say Ohio is an anomaly, and its cost overrun was solved when provider participation was expanded.
Proponents also contend the federal program’s cost overruns in Missouri would be reduced. Calculations by the Missouri Budget Project show expansion would result in $150 million in state general revenue savings and new tax revenue every year.
The assessment figures in a reduction in the state’s costs to the federal program, an increase in tax collections with the expansion, and projected savings when newly insured people no longer make exorbitant emergency room visits.
House Budget Committee Chairman Scott Fitzpatrick of Shell Knob is highly doubtful such a feat can be accomplished.
“I’d like to see them map that out on a white board for me, how making more people eligible for a service that’s costing us billions of dollars per year is going to save the state money” said Fitzpatrick. “Nobody’s been able to explain that for me in a way that I agree with.”
Like Fitzpatrick, a majority of Republicans oppose Medicaid expansion as a budget buster. Senate Minority Leader Gina Walsh (D-Bellefontaine Neighbors) defends the move against GOP member who say it would break the state’s bank.
“It’s going to break the bank if we don’t expand Medicaid too. And you and I are going to pay for it because you have good job, and I have a good job. These costs will get passed on to everyone else, as we’ve always said.”
Schupp has filed bills for Medicaid expansion for the past several years. They’ve seen little action in the GOP dominated legislature.