Rally not enough to spur health care expansion

Thursday, February 26, 2009 | 11:27 a.m. CST; updated 11:27 a.m. CDT, Thursday, September 3, 2009

JEFFERSON CITY — Hundreds of people rattling pennies in plastic piggy banks rallied Wednesday at the Capitol for expanded government health care. Republican lawmakers responded with a resounding no.

Moments after a crowd chanted and cheered for Democratic Gov. Jay Nixon's plan to expand health care to children, the Republican-led House Budget Committee axed the governor's proposal.

Republican budget writers said it would be wrong to expand a program in a midyear spending bill. They also doubted the state could afford it.

Nixon insisted the plan is affordable, and he vowed to continue fighting for it.

"We must convince a bipartisan group of legislators that it will be difficult to move Missouri forward unless we have a healthy Missouri," Nixon told those rallying in the Capitol Rotunda, shortly before the committee vote.

The health care clash is an encore of the intense battles of 2005, when then-Gov. Matt Blunt and the Republican-led Legislature eliminated Medicaid coverage for about 100,000 low-income adults and reduced benefits for hundreds of thousands of others. Activists for the poor and disabled repeatedly rallied at the Capitol that year, once even chaining their wheelchairs to the door of the House.

On Wednesday, many of the rally participants wore T-shirts that said "Medicaid Makes Cents." Organizers said they passed out 500 piggy banks to the participants, who rattled them for effect in the echoing Rotunda and then were supposed to distribute them to lawmakers.

Blunt did not seek re-election last year, and Nixon campaigned with a pledge to fully restore the 2005 Medicaid cuts.

But Nixon's first proposed budget does not go that far. Instead, he is seeking to restore coverage only to some of the adults cut four years ago and to expand coverage for children.

Nixon has proposed spending nearly $7.4 million in the current year's budget to expand the State Children's Health Insurance Program, which provides coverage to children whose families earn too much to qualify for Medicaid but cannot afford private insurance.

Among other things, his proposal would eliminate premiums for families earning up to 225 percent of the poverty level, or $49,612 for a family of four, while lowering premiums for others who earn more. The plan is projected to add 2,129 children to the rolls in the 2009 fiscal year and 19,153 during the 2010 fiscal year, which starts July 1.

But House Budget Committee Chairman Allen Icet said it was irresponsible to start expanding programs in legislation designed to fill fiscal gaps, such as boosting how much can be spent on gasoline because of high fuel prices.

"I'm reluctant to create new programs or expand programs because then it's game on — you have a whole new budget," said Icet, R-Wildwood.

House Democrats spent about an hour trying various tacks to restore money for Nixon's proposal in a hearing that grew increasingly contentious.

Rep. Jonas Hughes, D-Kansas City, tried to move money from several areas, including highways and feeding state prisoners, to expand funding for children's health care. He asserted that many inmates have children who would benefit from the health insurance program, and he predicted they would be willing to sacrifice for their kids.

Rep. Mark Bruns, R-Jefferson City, argued with Hughes, and at one point the two spoke over each other loudly as they debated the consequences of reducing money for prison food. Bruns said if the state spends much less on inmates, "we'll be to bread and water." Hughes disputed that.

Some of those at the rally rejected assertions that the state cannot afford to expand government health care. They pushed not only for Nixon's children's health plan, but for a full restoration of the 2005 Medicaid cuts.

The recently passed federal stimulus bill includes an estimated $1.2 billion of enhanced Medicaid funding for Missouri over the next two years.

"With the federal stimulus money coming in and with the economy the way it is, there is no reason we shouldn't do this," said Courtney Zimmerman, of the Viburnum-based Disabled Citizens Alliance for Independence.

Later Wednesday, the Senate debated but took no vote on legislation by Sen. Joan Bray, D-St. Louis, that would enact Nixon's children's health care plan, expand Medicaid eligibility for the elderly and disabled and allow some businesses to buy insurance through the state employee health care plan.

The bill also would also create a commission to study how Missouri can get to universal health coverage.

"I see it as a basic commitment like food and shelter," Bray said.

Senate President Pro Tem Charlie Shields, R-St. Joseph, said he shares the desire to expand access to health care but is worried about a government-run system.


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Ayn Rand February 26, 2009 | 3:18 p.m.

Take a look at what happened when Hawaii launched the first state-based "universal" child health insurance program. 85% percent of enrollees previously had health insurance. Dr. Kenny Fink, an administrator in Hawaii's Department of Human Services, said: "People who were already able to afford health care began to stop paying for it so they could get it for free. I don't believe that was the intent of the program."

Seven months later, Hawaii shut down the program.

Why pay for something if you can get it for free? Too bad it's not really free.

(Report Comment)
John Schultz February 26, 2009 | 3:36 p.m.

Ayn, that is similar to reports I have seen (from the Cato Institute perhaps) that six in ten SCHIP enrollees had previous private insurance. Would be interested to know if Missouri keeps similar figures and has any preconditions on people dropping their kids from their private insurance before enrolling in the Missouri program.

(Report Comment)

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