House poised for major Medicaid cut

Democrats have been
unable to block the change
Thursday, April 7, 2005 | 12:00 a.m. CDT; updated 12:21 p.m. CDT, Friday, July 18, 2008

JEFFERSON CITY — House lawmakers are poised to send Gov. Matt Blunt’s proposed Medicaid cuts to his desk. A vote could come as early as today, which is when the time for debate is set to expire.

Discussion opened Wednesday on the governor’s cuts, which would remove tens of thousands of Missourians from the Medicaid rolls. Democrats rallied to amend the bill, but their efforts were rebuffed repeatedly by a united Republican majority. Any changes in the legislation would require it to be sent back to the Senate, where it was ensnared in a 17-hour filibuster last month.

Medicaid is a joint program between the federal and state government that provides health care to the poor, elderly and disabled. It covers nearly 1 million Missourians and accounts for more than a quarter of the state’s expenses.

The bill, SB 539, is a companion to Blunt’s proposed budget. Together, they’re part of a Republican push to overhaul a state program that the governor and other Republicans describe as being out of control. They say the cuts, which would drop an estimated 100,000 people from Medicaid, are unavoidable without raising taxes or cutting education funds. They cite Missouri’s budget shortfall, which estimates place between $600 million and $700 million, as the cause.

Besides scaling back a number of services, the law would eliminate the entire Medicaid program in 2008. A commission of legislators would be charged with developing recommendations for alternatives. After that, the General Assembly would have to come up with a replacement system before the old one dies off.

House Democrats rose often to criticize the cuts as cruel, but none offered an alternative method for closing the budget gap.

“It’s the governor’s job to lead, and he’s failed to come up with a comprehensive vision for Missouri’s health care,” said House Minority Leader Jeff Harris, D-Columbia. “Don’t cut senior citizens off of health care and then set up a commission. You’ve got it backwards.”

Throughout the 1990s, Missouri’s Medicaid rolls swelled. When the late Democratic Gov. Mel Carnahan took office in January 1993, just over 510,000 Missourians were enrolled in the system. According to the state’s latest estimates, nearly 1 million are covered today. The nearly 40-year-old program’s $4.8 billion price tag accounts for more than 28 percent of the current state budget.

During his campaign last fall, Blunt said cutting back on Medicaid eligibility would be inappropriate. Now he says it’s the only way to avoid raising taxes.

House members in favor of the cuts described the bill as bringing reform to a bloated system.

“This is what we are trying for with this bill, is to have something that’s reasonable and fair, that puts the priority on those who are most in need,” said Rep. Jodi Stefanick, R-St. Louis County, the bill’s handler.

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