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Medicaid reform conversation continues in Missouri

Teddy Nykiel


Although the Missouri legislative session has ended, the discussion on what to do with the state’s Medicaid program continues.

The Affordable Care Act asks states to expand their Medicaid eligibility to cover those who earn up to 138 percent of the federal poverty level. That’s about $30,000 for a family of four. Missouri’s Republican-majority legislature has refused to expand Medicaid, calling it a broken system. Now, both the state House and Senate have established interim committees to study ways to reform Medicaid.

Neither committee has come out with an official plan or timeline. The day before House Speaker Tim Jones (R-Eureka) announced that he’s established the House interim committee on Medicaid reform, its chair, Rep. Jay Barnes (R-Jefferson City), canceled an interview with KBIA about his plans for the committee.

For his part, Speaker Jones identified some key groups he wants the House committee to include.

“I want to hear from the not-for-profits, who many of them provide health care through their fundraising to folks,” Jones said. “We’re going to have doctors on the committee. We’re going to have other health care experts in the committee. We’re going to have budget experts so we can talk about the impact to the budget.”

Republicans have said they want to introduce deductibles and co-pays into the Medicaid program. During session, Barnes sponsored a bill that would do so, in addition to getting private insurers to cover Medicaid recipients and introducing cash incentives for recipients that keep their health care costs low. 

In separate interviews, Sen. Kurt Schaefer (R-Columbia) and Rep. Shawn Rhoads (R-West Plains) said deductibles and co-pays are ways to give Medicaid recipients more “skin in the game” and be more invested in their own health care.

Schaefer repeatedly cited the statistic that show Medicaid recipients having a higher rate of failing to meet their physician appointments. Physicians still charge Medicaid for no-shows. 

Andrea Routh is executive director of the nonprofit Missouri Health Advocacy Alliance, a coalition of about 50 consumer groups across the state. The coalition supports Medicaid expansion. Routh said lawmakers don’t understand that many low-income Medicaid recipients miss appointments because of transportation difficulties, not because they aren’t invested in their own health care. 

Routh said she’s ready to provide testimony and information at the interim committees’ meetings, but hopes that lawmakers can get beyond the talking points they’ve repeated during session. 

“We don’t wanna see this conversation go away,” she said. “We want legislators to get informed about Medicaid expansion, to explore reform ideas, I think that’s great.”

Harum Helmy started as KBIA's Health and Wealth reporter in January 2013. She has previously worked at the station as a news assistant, helping assign and edit stories by student reporters. Harum grew up in Jakarta, Indonesia and graduated from MU with degrees in journalism and anthropology in 2011. She's trying to finish up an MA in journalism.
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