While Missouri Governor Eric Geitens has been less than clear if he’ll call more special legislative sessions on the heels of one already completed, at least one lawmaker has been straightforward about her plans.

Representative Tila Hubrecht, R-Dexter (photo courtesy; Tim Bommel, Missouri House Communications)

Representative Tila Hubrecht, R-Dexter, will leave her post June 4th, citing personal reasons.  She’s hoping to have departed in time for a special election to take place so a replacement lawmaker can finish out her two year term, which ends in November of next year.

Hubrecht is a nurse with a passion for health care who plans to stay vocal about the industry’s challenges as the needs of the giant baby boomer generation are set to peak in 2030.  She plans to combine her legislative experience with her medical background to address problems with health care.

“I think I definitely have raised an awareness, which is something that’s been very important to me” said Hubrecht.  “And then I’ve been able to work with the departments, like Social Services as well as the Department of Health, to talk to them about rules and regulations that are great for patient care and quality, as well as cost effectiveness.”

One thing Hubrecht would do is relax some of the regulations associated the delivery of Medicaid.  The government health care program comprises close to a third of the state’s $28 billion annual budget.

Hubrecht contends the cost is partially driven regulations on providers.  She says compliance requirements are a burden on all providers – hospitals, nursing homes, doctors.

“They’re constantly worrying about com-pliancy.  And chasing that forever com-pliancy goal of trying to make sure that you’re compliant with the feds, and with the states, drives up costs that may or may not be necessary.”

Among other things, Hubrecht would address costs by restructuring what’s known as the “certificate of need” process in Missouri.  Certificate of Need (CON) programs are aimed at restraining health care facility costs.

The premise behind CON regulation is that excess capacity stemming from overbuilding of health care facilities results in health care price inflation.

“If we could restructure CON process, I think we could some stability, because right now rates are based on when your facility was built, rather than more of a regionalized approach” Hubrecht said.

Another issue tied to the needs and costs of health care, according to Hubrecht, is the availability of doctors.  She says rules should be changed to allow nurse practitioners to offer services up to the scope of their abilities.

“That is huge.  That will really drive down costs.  Because right now in many of our areas throughout our state, we do not have access to care because there is not a care provider there.  We have nurse practitioners. But they can’t practice because there’s not a physician provider that they can collaborate with.”

Hubrecht also differs with many of her Republican colleagues on what the future of Medicaid and Medicare should be.  Many GOP members have long wanted to eliminate the government health programs in favor of market based replacements.

National Republican lawmakers released a 17-page paper earlier this year which claimed Medicaid is too costly.  It said “On its current path, the Medicaid program is on unsustainable financial footing”.

Hubrecht thinks her fellow party members may tend to forget the human element when considering health care costs.  “When they talk about Medicaid recipients and what not, I actually see faces.  I see patients that I’ve cared for.  I’ve seen people that I’ve held their hand while they died.  So when they talk about recipients, it’s not just words and numbers.  I see faces.”

State Representative Scott Fitzpatrick, R-Shell Knob, who chairs the House Budget Committees, often points to Medicaid as a drain on the state because of its soaring cost increases.  Hubrecht thinks both Medicaid and Medicare can be made sustainable and solvent.

“Absolutely.  It’s going to take, definitely, creative thinking, thinking out of the box, and removing rules and regulations and policies that drive up costs that are not backed up by evidence based research.”

Hubrecht is also not opposed to Medicaid expansion, which has been embraced by numerous Republican governors around the country, but has seen fierce opposition by GOP lawmakers in Missouri.  She said “If Missouri does not decrease regulation, then Medicaid expansion should be seriously considered.”