GUEST COLUMN: Common sense answers for affordable health care

Tuesday, March 24, 2009 | 8:05 p.m. CDT; updated 11:09 a.m. CDT, Tuesday, May 4, 2010

More than 720,000 Missourians have no health insurance, but Missouri has an unusual and wonderful opportunity to make a significant advance in solving this problem.

Governor Jay Nixon and the Missouri Hospital Association have devised a creative, financially sensible solution. The hospitals have agreed to tax themselves $52.5 million and use that money as the match to draw more than $90 million of federal funds to Missouri. If this historic agreement were to be adopted by the legislature, the money would then be used to extend health care coverage to nearly 35,000 adults, all of whom are parents and all of whom are below 50 percent of the poverty level.  

Hospitals currently receive federal funds to treat poor, uninsured patients. People without any way to pay for health care — thousands of Missourians — go to the emergency room as their first point of medical contact. But emergency care is much more expensive for hospitals — and patients — than routine, non-emergency care in doctors’ offices or public health clinics.

The hospital association, therefore, thought it was both in its fiscal interest and in the health care interests of thousands of Missourians to help solve the problem. It reached an agreement with Gov. Nixon to pay the state $52.5 million per year, $14 million more than it is currently paying. This payment would allow the state to qualify for an additional $93 million in federal matching funds. If Missouri does not apply for these matching dollars, the $93 million in federal dollars is simply allocated to another state’s health care system.

To emphasize — the hospitals pay the state $52.5 million, generating a federal match to the state of $93 million. Missouri is $145 million per year better off. More importantly, these funds would allow 34,800 low-income adults to receive needed, primary, Medicaid-eligible health care.

This increase in health care can be accomplished with no new state general revenue and no stimulus dollars. It is not a temporary solution. It is a permanent solution. It incurs no future obligation to the state.

All the state legislature has to do is to raise the Medicaid eligibility limit to 50 percent of the federal poverty level. Missouri caps Medicaid eligibility at 20 percent of the federal poverty level — for a family of four, that’s a maximum income of $4,410 per year. If the Medicaid eligibility level were raised to 50 percent of the federal poverty level, a family of four earning up to $11,025 per year would then be eligible.

Every reasonable Missourian will understand that providing medical coverage to low-income working parents makes sense when we can do so at no new cost to Missouri taxpayers. Being poor or being out of work should not make a family any less deserving of health care than the families of state legislators. Let’s not let a commonsense solution to a serious problem be thwarted by blind partisanship.

The Democratic minority members of the House of Representatives can’t do it alone — the numbers aren’t with us. We don’t have the votes. It’s up to the people of Missouri to convince the Republican majority that they’ve gone too far; that working people need health care; and that we are all better off for it.  

Chris Kelly is the state representative for Missouri's 24th District, which includes Columbia.

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John Schultz March 25, 2009 | 1:58 a.m.

Chris (assuming you read this), is there anything that keeps the hospital association from unilaterally revoking this tax increase in the future and putting the onus back on the state to provide the missing funds or cut services?

(Report Comment)
Jim Dailey March 25, 2009 | 10:54 a.m.

The Honorable Chris Kelly,
I whole heartedly agree that every American citizen should have proper health care benefits, not just Missourians underpriviledged or not. When one defines "health care" is it simply hospital visits or does it extend to pharmaceuticals as well? But what else does health care mean? Could it encompass mental health as well? Mental health care is, in my humble opinion, as serious a need as pre-natal care for uninsured mothers to be as well as other life-enhancing/life-saving treatments. Typically, the mental health patient has no health insurance due to myriad factors one of them perhaps being the inability to obtain and/or retain gainful employment with companies that offer insurance.

Health care is not just broken bones, it extends to broken minds and when the State of Missouri, under the leadership of Governor Jeremiah,(Jay),Nixon seeks to remove large parts of the Department of Mental Health budget, namely Mid-Missouri Mental Health Center, he is essentially limiting health care in Missouri. We can gloss this over and say that mental health is not lost in Mid-Missouri because of the proposed and eminent gifting of the facility to the University Health Care System, however, what they propose to do with the facility is yet undetermined.

It is entirely possible for the State of Missouri to keep the facility. There are financial solutions to the problems within the Department of Mental Health vis-a-vis Mid-Missouri Mental Health Center that could have the facility perform within or below reasonable fiscal guidelines. It is possible, it is realistic, however, the solutions are overlooked. The State Auditor's office is ill-equipped (politically, if for no other logical reason) to handle the task, on the Legislation side there are few(if any), who are want to step out in front of this issue and challenge the will of the new Governor's budget suggestions. What it takes is an insider, someone who knows the day-by-day waste that happens within the facility. All of this is just so much folly, we are a day late and a buck short (or perhaps 20 million as it were). I know of viable solutions, I possess an uncanny knack for cutting waste, I have done it before in other industries, it could have been done here, the facility could have been salvaged, saved. It is too late, the die has been cast.
Your Honor, I leave you with two quotes and my most humble appreciation for reading my reply.

"I shall weep for thee, for this revolt of thine methinks is like another fall of man"
Shakespeare, Henry V

"It is no measure of health to be adjusted to a sick society"

(Report Comment)
Steven Slim April 13, 2009 | 5:58 p.m.

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