A Missouri public policy group says legislation in Congress that aims to replace Obamacare would deeply impact the state’s budget. Amy Blouin, executive director of the Missouri Health Partnership, says proposals being considered by the U.S. House and Senate include a cap on federal funding to states that would reduce over time.
According to Blouin, the House bill would cut federal funds to Missouri by at least $3 billion during the first ten years. She says that figure could be closer to $4 or $5 billion if the Senate version is adopted.
Blouin and the Missouri Health Partnership, a coalition of health providers, advocates and other organizations, are speaking out against the proposals.
“We’re very concerned, says Blouin. “Not only does that impact people and access to healthcare, it impacts the economy as well, particularly the rural economy.”
Many rural hospitals are financially strapped and rely heavily on Medicaid funding to help cover the cost of services and staff. A recent study says the number of rural elderly Missourians who are dependent on Medicaid services is twice that of urban elderly residents.
According to the Missouri Department of Social Services, the counties with the lowest Medicaid enrollment are St. Charles (7.1%), Platte (7.8%), Nodaway (9.4%) and Osage (9.5%). The counties with the highest Medicaid enrollment are in southeast Missouri’s Butler (29.3%), Mississippi (29.4%), Ripley (32.4%), Dunklin (37.2%) and Pemiscot (38.8%).
Blouin says the measures also include changes to provider assessments that would increase Missouri’s costs by a few hundred million dollars per year. She says the bills would force state policymakers to consider budget cuts, tax increases and Medicaid cuts.
“Those cuts could reduce eligibility for Medicaid services, impacting kids, seniors, or people with disability who are largely the folks who can participate in Missouri’s Medicaid program or reduce the types of services they receive,” says Blouin.
About 51% of Medicaid funding comes from the federal government. The federal match is $1.72 for every $1.00 spent by Missouri. The legislature previously passed a law requiring health providers to pay for 32% of Missouri’s Medicaid costs.
A revised plan released by Republican includes an amendment by Sen. Ted Cruz, R-Texas, which would allow insurers offering Obamacare plans to also offer cheaper, bare-bones policies. The amendment was included to try to garner more support from conservatives, but it could also steer away some moderates who fear the amendment could escalate premiums for Americans with pre-existing conditions.
The plan also preserves Obamacare-era taxes on wealthy Americans’ investment income for five to seven years. Some GOP members say the federal government could direct the taxes to a fund that could to help cover consumers’ health care costs while the new GOP plan rolls out. Republicans hope the changes will earn support from moderates.