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Missouri legislative panels to consider Medicaid expansion for next session

By Mike Sherry for KHI News Service, June 3, 2013

KANSAS CITY, Mo. – A bipartisan group of Missouri lawmakers expressed optimism Friday that the General Assembly could expand the Medicaid program next year.

“I think there is a very good chance of reaching a compromise,” said Sen. Wayne Wallingford, a Cape Girardeau Republican.

Wallingford and fellow Republican Sen. David Pearce, of Warrensburg, were part of a legislative panel put together by Partnership for Children as part of a luncheon discussion of this year’s General Assembly session, which concluded two weeks ago.

The event drew about 85 people to the Kauffman Foundation Conference Center.

Medicaid expansion was one of the most divisive issues of the session, and the GOP-dominated General Assembly rebuffed efforts by Democrats to expand the program’s eligibility to people living at up to 138 percent of the federal poverty level -- roughly $15,200 for an individual and $21,300 for a family of four.

Under the Affordable Care Act, the federal government has pledged to pay 100 percent of the expansion costs for three years, starting in 2014. After that, states would have to contribute 10 percent of the cost.

In upholding the law last year, the U.S. Supreme Court left it to the states to decide if they wanted to expand Medicaid.

Missouri legislative leaders have talked about establishing legislative panels to study the Medicaid issue prior to next year’s session.

It appears the Senate and House will have separate committees, said Erin Brower, Partnership for Children’s director of advocacy and public policy.

Brower said expansion advocates hoped the committees would not be stacked with implacable foes of the idea.

“We are looking for people to be on it who are really looking for a solution,” she said.

Wallingford and Pearce both said they voted against the expansion this year. Both said they were concerned about the long-term costs to the state.

Gov. Jay Nixon, a Democrat, argued that the federal payments during the first three years would bring in about $5.7 billion to the state to expand coverage to approximately 300,000 uninsured Missourians.

He also argued that the economic benefits of the expansion, such as the need to hire more healthcare workers, would increase state revenue.

“This discussion will continue,” Pearce said.

He and Wallingford said that reform of the Medicaid program also must be part of the discussion.

For instance, Wallingford said, other states have successfully cut costs by moving to managed care for participants who are eligible for both Medicare and Medicaid, a group that tends to need a lot of services.

Sen. Paul LeVota, an Independence Democrat, said the two sides could reach agreement, if everyone toned down the political rhetoric.

Republican leaders “are all very reasonable people,” he said. “They want to solve problems.”

The message should be this, LeVota said: “Let’s figure this out. Let’s make this a Missouri decision. Let’s not do exactly what the federal government wants us to do all the time. Let’s make it where we can leverage this money and reform Medicaid the way we want to do it.”

In assessing the overall session, Charron Townsend, Partnership for Children president, said, “There were some victories and there were some disappointments.”

Though Partnership for Children counted this year’s defeat of Medicaid expansion as a significant disappointment, the organization saluted Pearce and Wallingford for their efforts in passing legislation the organization supported.

Pearce is chairman of the Senate Education Committee. Brower noted his resistance to GOP economic proposals that critics said limited funding to an already underfunded education system.

She said his stance included opposition to an income tax measure that passed the General Assembly. Nixon has until July 14 to decide if he wants to veto the bill.

Partnership for Children recognized Wallingford for sponsoring a measure known as Jonathan’s Law.

The measure takes its name from Jonathan McClard, a teenager from Jackson, Mo., who hung himself in prison five years ago after a court sentenced him as an adult. He was 16-years-old when he was sentenced to 30 years in prison for first-degree assault for shooting another teenager.

Wallingford’s measure aims to direct more young offenders into juvenile facilities operated by the Division of Youth Services, where proponents said offenders have a better chance of rehabilitation than they do in state prison.

The measure would amend current law that gives courts the option of imposing a juvenile sentence on offenders under the age of 17 who are certified as an adult. Wallingford’s bill would extend the age limit by six months.

The Health Care Foundation of Greater Kansas City is proud to partner with the KHI News Service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. Because it is committed to objective coverage, HCF exercises no editorial control over the content. The KHI News Service is an editorially independent initiative of the Kansas Health Institute.

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