April 21, 2014

House Republican Medicaid plan sponsor undeterred by Senate Republican comments

Work will continue on a House Republican proposal that would reform Medicaid and expand eligibility in Missouri, despite Senate Republicans reaffirming their opposition to Medicaid expansion. A House Committee will hold its third hearing on the proposal, HB 1901 sponsored by Representative Noel Torpey (R-Independence), early Tuesday in the basement of the Capitol.

“There is no path for Medicaid expansion to occur in Missouri this year,” said Brad Lager (R-Savannah) on Monday, one of five Republican Senators who said they would block any attempt to expand Medicaid eligibility this session.

“If we’re going to allow five people to run the state, that’s unfortunate,” says Torpey. He agrees that expansion by itself will not succeed in the Republican-controlled Missouri legislature.

“That was evident last year,” Torpey tells Missourinet, “but if people want reform and truly want reform, we’re going to have to do some type of eligibility changes, and so they’re linked together.”

Torpey says the Senators’ comments won’t cause him to do anything differently.

“Things can change in politics in a day, let alone eight weeks,” says Torpey.

House Speaker Tim Jones (R-Eureka) says the opposition to expansion is not limited to the Senate.

“The signals I’m receiving from the (House Republican) caucus and the signals I’m receiving from the Senate are that expansion is simply something that the legislature does not have much of an appetite for this year,” Jones says. “They’re very concerned about the long-term effects on the budget, and I share those concerns.”

Torpey thinks stripping out the expansion components of his legislation would not be successful either.

“I really think it’s a partnership,” says Torpey of reform and expansion of Medicaid. “We get both or nothing.”

The hearing Tuesday will focus on three aspects of Torpey’s bill, including increased eligibility in some populations.

Earlier stories:

Hearing highlights work requirement, premium in House Republican Medicaid plan

House Republican files Medicaid expansion, reform proposal

Hearings continue on proposed Medicaid reform, expansion plan

A House Committee will continue its hearings on a Republican proposal for reform and expansion of Medicaid Monday afternoon and Tuesday morning.

The Committee on Government Oversight and Accountability will hear Monday at 2 p.m. the portions of the legislation dealing with health care homes, managed care, and managed care requirements. In a hearing Tuesday beginning at 8 a.m. the committee will discuss the “Show-Me Healthy Babies program,” proposed to provide medical coverage to unborn children through the Children’s Health Insurance Program (CHIP), increases in eligibility, and coverage for high-cost Medicaid recipients with complex medical conditions who would fall under a new category of “medically frail.”

The hearings will take place in Hearing Room 3 in the basement of the State Capitol.

The proposal is HB 1901, sponsored by Representative Noel Torpey (R-Independence).

Earlier stories:

Hearing highlights work requirement, premium in House Republican Medicaid plan

House Republican files Medicaid expansion, reform proposal

House endorses tax credit increase for pregnancy resource centers

The House has given initial approval to a bill that would increase the amount available in tax credits for pregnancy resource centers from $2-million a year to $2.5-million beginning in fiscal year 2015.

The centers offer doctor services, counseling on alternatives to abortion, and assistance with finances, budgeting and long-term support to women primarily between the ages of 16 and 24 who are dealing with unexpected pregnancies. Proponents say the centers keep those women from having to get such support from the state and so represent a good use of state tax dollars.

The centers have been criticized, however, by supporters of abortion rights, who say some centers present deceptive information regarding abortion. Those who oppose the bill say the state should not support such activities with tax credits.

Representative Genise Montecillo (D-St. Louis) raised that issue to the bill sponsor, Representative Kevin Engler (R-Farmington).

“Most of them do wonderful work,” says Montecillo, “I just want to make sure women are getting good and accurate medical information so they can carry their children to term safely.”

Engler says he shares her concern.

“Most of the bills that your members are going to focus on from that area are going to get killed. That’s just the reality,” Engler tells Montecillo. “I’d like to work with you on coming up with something … maybe not legislative … that we can put out and say, ‘This is what you can do. You are getting tax credits from the State of Missouri, therefore you need to have some responsibility of doing things.”

Engler says the award of tax credits to those organizations and whether they are presenting accurate information becomes an issue of upholding the State Constitution in his mind.

Another favorable vote would send that measure to the Senate.

The bill is HB 1132.

Chemotherapy parity bill clears legislature (AUDIO)

Many Missouri Cancer victims are on the verge of getting more affordable treatments.

The legislature has sent Governor Nixon a bill requiring insurance companies offering Cancer treatment coverage to make oral chemotherapy coverage less costly. The bill says the companies cannot charge more than $75 a month more for oral chemotherapy coverage then they charge for injectable treatments.

The Senate passed the bill two weeks ago.  The House passed it today.  It goes into effect as soon as Governor Nixon signs it.

House sponsor Sheila Solon of Blue Springs says 25-35% of the new cancer treatments are in oral form.  “This is a revolutionary new way that we’re going to be treating cancer in the future,” she says.   

Supporters of the bill say the new coverage law will make Cancer treatments easier and more convenient.   “Many times the oral chemotherapy directly targets the cancer cells,” Solon says. “Patients don’t get as sick. They don’t lose their hair and they’re not nauseous.”  The use of chemotherapy pills also means patients don’t have to travel to hospitals for treatments, which can last several hours.  

Solon says the $75 limit on additional premiums is important because “when patients, out of pocket,  exceed the $100 they start splitting pills (and) skipping days.” 

Before today’s House session, Solon was joined by Majority Floor Leader John Diehl and Speaker Tim Jones for a brief news conference:

AUDIO: News conference




House sends medical malpractice cap legislation to the Senate

The state House has passed legislation to reinstate caps on the amount that could be awarded to plaintiffs for non-economic damages in medical malpractice lawsuits. The bill would limit those damages to $350,000.

Representative Eric Burlison (Photo courtesy; Tim Bommel, Missouri House Communications)

Representative Eric Burlison (Photo courtesy; Tim Bommel, Missouri House Communications)

Proponents say the legislation would keep medical malpractice insurance premiums paid by doctors lower, making it easier for doctors to stay in business in Missouri and keeping down the cost of health care. Opponents say it infringes on the rights of Missourians to have a jury decide what appropriate damages would be.

See our earlier story on the medical malpractice cap legislation

Representative Stanley Cox (R-Sedalia) argued for the legislation, saying it will keep doctors from making the decision to leave Missouri for a state that does limit those damages.

“They make decisions based on economics,” Cox says of doctors, “and if you can go 80 miles west of Sedalia and practice in a more hospitable environment, you might make that decision.”

Representative Stephen Webber (D-Columbia) says the legislation will put more control over the care of patients in the hands of insurance companies rather than doctors.

“The truth is that this bill will make it more difficult for doctors to get the approved treatment, to get the approved tests, approved by the insurance company to take care of their patients,” Webber argues. “This will make it more difficult for doctors to do the thing they love more than anything else in the world, which is make sure their patents get quality treatment.”

The legislation, HB 1173 sponsored by Representative Eric Burlison (R-Springfield) was sent to the Senate 94-61.