Medicaid

In last week's House debate on autism insurance legislation, Rep. Rob Schaaf (R-St. Joseph) proposed an amendment that would expand Medicaid to cover all newly-born children with autism.  His amendment was ultimately defeated by a 65-87 vote, presumably because of concerns about the cost of the bill. 

During the floor debate, Schaaf was asked to explain why he wasn't trying to cover more children with Medicaid. Schaaf's response was pretty...incredible.

QUESTION: You're saying we have the huge payoff under autism, by paying covering these children who are autistic.  And the state's going to get a large payoff over time because we're going to drive those expenses down, and ultimately there will be a payback to the state.  What's the difference on that -- or would you agree -- that we'd have just as much benefit to the state if we covered children with leukemia and children with heart problems, because those children with autism can currently also go to the high risk pool?

SCHAAF: No, but they can't get ABA [applied behavior analysis] in the high risk pool. They can't. It's not available. But the kids with leukemia and heart problems, instead of being a burden on the state for 65 years, they'll just die of leukemia and heart problems.

Like Lt. Governor Peter Kinder, House Republican leaders are going out of their way to ignore the facts and overstate the projected costs of expanded Medicaid edibility as outlined in the House- and Senate-passed health care reform bills.  Today, eight GOP leaders, including Speaker Ron Richard, Floor Leader Steven Tilley and Speaker Pro Tem Bryan Pratt wrote Gov. Jay Nixon and Attorney General Chris Koster to express their disdain for the federal proposals. 

Republicans opposing health care reform en masse isn't news -- but the refusal by Missouri GOP leaders to talk about the proposed legislation should be.  From a story posted today on the Star's Prime Buzz blog:

Republicans contend that could cost the state an additional $450 million a year, based on estimates released by the state Department of Social Services several months ago. Figures reflecting new iterations of the bills haven't been released, they said.

This is false, and you don't have to take my word for it.  As printed in the News-Leader last week:

Kinder's claim that the Medicaid expansion could cost Missouri taxpayers "as high as $450 million per year" is much higher than what Nixon's Department of Social Services claims the House or Senate bills would cost Missouri.

DSS officials estimate the House version of Medicaid expansion would cost the state of Missouri $188 million more each year, while the Senate bill would cost state taxpayers an extra $91 million each year.

Peter Kinder still can't be bothered to use reasonable, correct estimates for how expanded Medicaid requirements will impact the state. The News-Leader (empahsis added):

On Dec. 30, Kinder sent a letter to Nixon, expressing his concern about the federal legislation and calling on the governor to state his position on the legislation.

Kinder's claim that the Medicaid expansion could cost Missouri taxpayers "as high as $450 million per year" is much higher than what Nixon's Department of Social Services claims the House or Senate bills would cost Missouri.

DSS officials estimate the House version of Medicaid expansion would cost the state of Missouri $188 million more each year, while the Senate bill would cost state taxpayers an extra $91 million each year.

From this morning's paper:

About 344,000 people in Missouri were uninsured in 1999. About 815,000 have no coverage now — an increase of roughly 137 percent.

You might expect that staggering growth to inspire a sense of urgency in Jefferson City. Instead, state legislators spent the past weeks spewing hopelessly out-of-touch political rhetoric...

House Republicans refused to expand Medicaid eligibility even with voluntary tax increases from Missouri hospitals. Hospitals wanted to provide $52.5 million a year. That would have generated $93 million in federal matching funds and permitted 35,000 poor working parents to get care.

Instead, we'll pick up 100 percent of the cost. That back-door tax increase — from a Republican Legislature, no less — is shifted onto those of us with private health insurance. That drives up premiums, which increases the cost of doing business in Missouri — exactly what we don't want during a recession.

Read the whole thing here.

Good: Missouri's hospitals and Gov. Nixon announced a plan to provide health care for almost 35,000 uninsured residents -- at no cost to the state.

• Hospitals agreed to increase their tax payments to qualify for more federal Medicaid money, allowing 34,800 currently uninsured Missourians to receive coverage.
• The plan would cost the state zero dollars.
• The hospitals are on board because it will save them money in the long run. The president of the Hospital Association says the proposal is "an opportunity we can't afford to miss."
• The Post-Dispatch says the plan is "good for poor, uninsured parents [and] it helps to create jobs."

Bad: Predictably, GOP leaders lined up against the health care plan.

• Why? Because, um, the hospitals don't like it, there are still other uninsured people, it costs the state money, it makes them look bad.
• GOP Budget Chair Allen Icet was really annoyed with Rep. Rachel Bringer for sponsoring an amendment to enact the plan. So like any mature adult, he decided that pettiness was the best response.