Friday, November 2, 2012

Missouri running out of time to decide on expanding Medicaid

Linda Spence is a 63-year-old full-time student at University of Missouri-Kansas City. After losing her job as a Program Director on the campus of UMKC, she has no health insurance because she does not qualify for Medicaid.
After the US Supreme Court ruled it unconstitutional for the federal government to force states into expanding their Medicaid coverage, Missouri now has a choice of whether or not to expand Medicaid for people like Linda Spence.
The Federal government will pay 100 percent of the financial burden imposed by Medicaid expansion for the first three years, but starting after the initial grace period, Missouri would start to become responsible for some of the cost. Starting in 2017, Missouri would be responsible for five percent of the cost in 2017 and 10 percent starting in 2022, according to state officials and advocacy groups.
Spence said she takes advantage of a discount at Truman Hospital for people with lower incomes. She said not many people know about this discount, and people who want it must apply for it. Spence also said without this discount, she would have no way of obtaining any kind of regular health care. She also said that not having insurance can affect the quality of health care she is able to receive.
"If I were able to qualify for something like Medicaid, granted I would have to qualify for it, but at least I would know it was something a little bit more guaranteed. I might have access to other physicians other than going through Truman. Maybe I would be able to choose my own doctor, for example. Go to specialists of my choosing, instead of just specialist that are available," said Spence.
A major concern legislators have with expansion is that it could take away a lot of funding from other areas of the budget, namely education.
"When you're looking at increases of potentially 100 or 200 million dollars that you have to find because of expansion, there is only one place where there is a pot of money big enough to take that, and that is public education," said Senate Appropriations Chair Kurt Schaefer, R-Columbia.
Schaefer said that there is no way around public education funding taking a hit with the Medicaid expansion, and if the true cost, is too detrimental to education then he would not be in favor of expansion.
Sen. Rob Schaaf, R-St. Joseph, thinks Missouri would have to pull funds from a diverse group of areas to fund expansion.
"I know from my experience as a legislator, that anytime one program absorbs up a bunch of resources, they try to spread the pain around everywhere else. So it isn't just education, every other program would suffer," Schaaf said.
Schaaf said Missouri does not have an obligation to use tax dollars to give able-bodied adults health care.
"We already take care of kids, and we take care of the disabled, and we take care of the elderly. These people are able-bodied, and it would be wrong for us to give them free health care and put them on Medicaid, and expect other working adults to pay for them," Schaaf, a licensed physician,  said.
For a single parent with one child to receive Medicaid under the current coverage in Missouri, their annual income would need to be less than $2,809.00, according to the Missouri Foundation for Health. The new program, should it be implemented in Missouri, would allow anyone at 133 percent of the federal poverty line to receive Medicaid. That covers a higher percentage of the poverty line than is currently afforded to people

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