Medicaid cuts move ahead

An amendment to a Senate bill would end the program by 2008.
Wednesday, March 16, 2005 | 12:00 a.m. CST; updated 2:59 a.m. CDT, Monday, July 21, 2008

JEFFERSON CITY — Thanks to a straight party-line vote on an amendment earlier in the day, the Missouri Senate voted to end the state’s Medicaid program when it gave first-round approval to a bill aimed at reducing Medicaid eligibility Tuesday night.

Senate President Pro Tem Michael Gibbons, R-St. Louis County, proposed an amendment that would eliminate the welfare program by June 30, 2008. The amendment modified the larger Senate bill that would cut 89,000 recipients and reduce coverage for another 23,000.

“This system is not getting health care to the people who are eligible,” Gibbons said. “It’s allowing people who are not eligible to access the system and take money away from people who really need it. It’s flawed, it’s bad, and it needs to go.”

State and federal programs fund Medicaid, the state’s largest welfare program. It pays health care expenses for almost 1 million low-income and elderly Missourians.

Gibbons said he thought the system would be changed well before the deadline outlined in the bill, but he said he “wanted to make an exclamation point to our commitment to change.”

Sen. Pat Dougherty, D-St. Louis, said setting an arbitrary date to eliminate such an important program was wrong.

“If this is a vision, then I don’t want any part of it,” he said.

Gibbons said he had no ideas about how to replace Medicaid but expected to work on ideas over the summer and hold hearings and create a new program next session.

The vote on the amendment came in the heart of a Democratic filibuster of the bill that lasted more than 17½ hours over the course of two days. The bill — which passed 20-12, with two Republicans dissenting — goes hand-in-hand with the governor’s proposed budget, making the cuts necessary to increase education spending. The bill still needs to undergo formal passage by the Senate before it goes to the House for approval.

Senate Democrats, however, said social services are not the place to make cuts. They said taxpayers would still have to pay for the care of would-be former recipients, whether it is through Medicaid or emergency room stays.

“These are hard decisions, but we don’t need to be hard,” said Sen. Yvonne Wilson, D-Kansas City.

Before voting to eliminate the entire program, the Senate voted to require more parents to pay premiums for children receiving Medicaid.

Proponents said the change would save state dollars, but Democrats said the change

would put 130,000 people at risk of losing their health care.

“This is a fine day for the Missouri Senate,” Dougherty said. “This is just a great day. Why don’t we all send a press release back home?”

At a news conference earlier in the day, Gov. Matt Blunt said Democratic detractors were defending an old, broken system and refused to accept needed reforms to verify eligibility requirements.

“People who are attached to the old way are opposed to social welfare reform,” he said. “People who are attached to the old way think we shouldn’t change our social welfare systems and that Missouri ought to spend a larger percentage of our budget on Medicaid than all but one other state.”

Democrats spent much of the day unsuccessfully proposing floor amendments to restore parts of the programs falling under the Republican ax.

Sen. Victor Callahan, D-Jackson County, criticized the governor’s plan and Republican senators for blindly accepting those plans.

“The stink of the executive branch is penetrating this legislature,” Callahan said.

As tempers flared and a filibuster raged two floors above in the Senate chamber, 16-month-old Evelyn Canada crawled from row to row inside a House committee room in the capitol’s basement.

Along with Canada were a gaggle of First Steps program enrollees and their parents who had gathered to prepare for a Senate committee hearing for a bill that would replace the program, which gives state aid to the guardians of disabled children from birth until age 3, with a similar program.

Blunt and Gibbons, the sponsor of a Senate bill to create the new program, pushed for the new program after Blunt’s proposal to eliminate funding for the program drew criticism from Democratic lawmakers and the families and friends of the more than 8,000 participants.

Malinda Terreri, the mother of a former First Steps program participant, said she stood to gain nothing more from the program but was concerned that future parents would not benefit as she did.

“We had a great program, and to go back to something that is middle-of-the-road or something that is not as great as it could be is a tough thing to do,” Terreri said.

Blunt has said he supported replacing First Steps with a program that would turn to private insurance before taxpayer dollars.

In a news release, Blunt said he proposed the changes “out of genuine concern” and that they would “enhance the delivery of services.”

But many of the parents of children involved in the program said the proposed new program was an attempt to grab political cover in response to widespread opposition.

The bill was heard in committee Tuesday afternoon, but no decision was reached.

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