Blunt’s cuts affect 90,000 statewide

Medicaid for older residents and disabled people is targeted.
Friday, January 28, 2005 | 12:00 a.m. CST; updated 1:28 p.m. CDT, Tuesday, July 22, 2008

JEFFERSON CITY — An official for Missouri’s hospital industry warned Thursday that the governor’s budget cuts for Medicaid could cause people with health problems to turn to emergency rooms for primary care — a decision that could adversely affect their health.

Dave Dillon, vice president of media relations for the Missouri Hospital Association, said the newly uninsured will wait as long as possible to see a doctor. If they do, patients will be turning to emergency rooms statewide as their conditions worsen because hospitals are required to care for any patient, regardless of health coverage.

“People will postpone their care, which will compromise their health,” Dillon said.

But Kurt Toebben, director of Medicaid and FRA for the hospital association, said hospitals are prepared to deal with this problem.

“Patients will absolutely be treated and no one will be turned away,” he said, adding that there are plenty of hospital beds to go around, especially in the St. Louis area.

Dillon also said the hospital association is planning to work with the governor through the appropriations process to stabilize Medicaid.

As for how hospitals plan to compensate for the costs of uninsured people seeking medical care, Dillon said money will not be a problem. The problem will come when costs are shifted to employers. Those patients who are uninsured will receive payment for their bill through charity care, depending on whether they are eligible for the program.

Administration officials estimated that nearly 90,000 Missourians would be removed from Medicaid coverage from the budget plan Gov. Matt Blunt proposed Wednesday night. Eligibility cuts would be extended to adults, older residents and those with disabilities. Under the plan, adults would have to earn an income that is 30 percent of the federal poverty level to be eligible, compared to the current 75 percent mark. A family of three, for example, could earn no more than $4,701 annually — instead of the current $11,752 — for the parent to qualify for health care.

At least 60,000 adults are expected to be affected, with more than 20,000 being eliminated from Medicaid pay. Likewise, 15,000 elderly individuals across the state who are currently receiving Social Security would lose Medicaid.

Blunt also plans to do away with Medical Assistance for Workers with Disabilities. The program provides coverage for employed persons with disabilities between the ages of 16 and 64. Eliminating the program will mean that a majority of people participating in the program will lose their coverage, despite being employed. Others will either be moved into another Medicaid category or to a spend-down program.

The new proposal also calls for cutting dental, podiatric, rehabilitation and specialty services for all those receiving Medicaid. Specialty services include optical, hearing and ambulatory services.

Pregnant women, children and the visually impaired would be exempt from the proposed cuts. The governor said continuing Medicaid for these groups would be “responsible uses of taxpayer dollars.”

According to the Missouri Social Services Department, there were 974,559 people in Missouri receiving Medicaid in 2004. In some counties, recipients accounted for one-fourth of the population or more. The state average is about one in 10 people.

Blunt’s budget plan calls for a reduction of $626 million in state and federal Medicaid spending. Minus that total, Missouri’s Medicaid budget will still be more than $5 billion.

The Associated Press contributed to this report.

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