The sponsor of a Medicaid reform proposal in the House says it wouldn’t get past the Senate this year, but what he calls his “mini-Medicaid” bill has reached the Senate.
Representative Jay Barnes (R-Jefferson City) brought up his Medicaid “transformation” proposal (HB 700) for about 40 minutes of discussion on the House floor before withdrawing it. He had offered it as an amendment to a smaller bill (HB 986), the main provision of which would create a House-Senate committee to study reform in the interim.
“It’s now my hope that … we can work together with leaders on this issue from the Missouri Senate. I think that there’s an interest in there in exploring paths forward.”
Barnes expressed frustration with the chamber on the opposite end of the Capitol when he withdrew the larger bill.
“Unfortunately the Missouri State Senate has indicate it does not have the stomach to pick up a Medicaid transformation bill this year. Rather than figure out how we can make the best out of a bad situation, they are seeding the field for another year.”
The smaller of the bills, 986, has been sent to the Senate. It includes an “emergency clause” attached to the provision that would create the interim committee, that would make that portion law immediately upon being signed by the Governor.
While debating that clause, Representative Jeff Roorda (D-Barnhart) was sarcastic in voicing his frustration that neither Medicaid expansion nor reform are advancing this year.
“Well what’s the gall darn hurry? 461 people die next year, 300,000 will go without health insurance, we’ll leave $941-million dollars on the table … I don’t see what the ’emergency’ is.” He added, “I’m going to support the emergency clause but I don’t want people to get the idea that [the House] is acting with any sense of urgency to address the biggest problem we have in our state right now.”
The proposed interim committee would be charged with creating a report by the end of this year that would cover: more efficient and cost-effective ways to provide coverage, how coverage can resemble commercially available coverage while meeting federal Medicaid requirements, possibilities for promoting healthy behavior and preventative care, the best way to provide incentives including a shared risk and savings to health plans and providers, and ways that a participant currently receiving coverage can transition to private sector coverage.
In addition to creating the interim committee, the legislation would extend the Ticket to Work program that helps people with disabilities get and keep jobs and increases Medicaid eligibility for foster children to age 26, the same age through which non-foster children are eligible to be covered by their parents’ insurance.
The bill would also change income eligibility determination standards to the individual’s modified adjusted gross income (MAGI) equivalent net income standard. Barnes says that will not increase eligibility, but would simplify the enrollment process.