A House Committee has held the first hearing of a Republican proposal for reform and expansion of Medicaid.

Representative Noel Torpey (photo courtesy; Tim Bommel, Missouri House Communications)

Representative Noel Torpey (photo courtesy; Tim Bommel, Missouri House Communications)

The first of three planned hearings to pick apart the bill has focused on reform components. Drawing the most criticism on the day are the proposals of a requirement that Medicaid recipients have a job, be looking for one or be a student, and that participants pay a premium of 1-percent of their income.

Saint Louis University law professor Sidney Watson tells the committee those might not be legal, and says there is a question of whether the secretary of the U.S. Department of Health and Human Services has the authority to grant waivers to allow them to become policy.

“The Secretary has never approved a straight premium charge that results in ineligibility for nonpayment,” says Watson of the premium proposal, “because of concerns that people earning below or near the poverty line can in any given month have problems coming up with those payment charges.”

The bill is written so that if those waivers aren’t both granted, the legislation as a whole would fail. Joel Ferber with Legal Services of Eastern Missouri urges the committee to remove that contingency.

“It just seems like a very potentially not very productive endeavor. I think the key is to either modify these two provisions or to loosen up the waiver provision so if you get 99.9-percent of the waivers you want you can still go forward.”

Committee Chairman Jay Barnes (R-Jefferson City) says he isn’t convinced those provisions would not be approved for waivers, and says they are key to the bill.

“I think it’s only fair that we require an able-bodied person to actually work before they qualify for Medicaid,” Barnes says. “I think Missourians are willing to help those who are willing to help themselves.”

Barnes hopes to have the next hearing on the Monday after next week’s Spring Break, with a focus on more reform components.

The legislation is HB 1901

See our earlier story on the legislation.