Philosophical differences emerge as the Medicaid Reform Commission wraps up its two-day meeting at the Capitol. Commission members have spent more time on eligibility and the financial requirements of Medicaid recipients than any of the other issues they have discussed. The Medicaid Reform Commission Chairman, Republican Senator Charlie Shields of St. Joseph, pushes for an increase in the co-pay Medicaid recipients pay for prescription drugs, a proposal that meets resistance from Democrat Representative Margaret Donnelly of St. Louis. Shields argues that Medicaid recipients need to have a financial stake in the program to keep from over-using it. Donnelly counters that many Medicaid recipients are so poor, they cannot afford any co-payments, even if they are as little as $1.50. Another proposal by Shields has caused controversy. Shields wants to vary co-pays and benefits among Medicaid populations. Those completely reliant on the state would not pay, but those with means would. Shields gives as an example, those who access Medicaid coverage, because their children are on Medicaid should pay higher co-pays and, perhaps, a small premium. Democrats counter that all should be treated equally. A proposal by a Democrat that eligibility guidelines should increase was met by Republican insistence that that was what wrecked the Medicaid budget. Both sides, though, agree some form of assistance for disabled workers will be restored. The legislature cut the Medical Assistance for Workers with Disabilities (MAWD) program this year. A preliminary draft will be written, summarizing the ideas discussed the past two days, for the commission’s consideration. The commission has a January first deadline to submit a report to the legislature.
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