Blunt reshapes Mo. Medicaid program, opponents nothing has changed

Monday, July 2, 2007 | 2:03 p.m. CDT; updated 6:36 p.m. CDT, Friday, July 18, 2008

JEFFERSON CITY — Gov. Matt Blunt signed legislation Monday reshaping Missouri’s Medicaid program to emphasize healthy living and restoring coverage to some of the many thousands who lost it because of budget cuts two years ago.

The Republican governor was promoting different aspects of the bill at each of his five scheduled signing ceremonies around the state, highlighting health care technology improvements, expanded coverage for children and women, and greater coordination of care.

The health care legislation was a priority for Blunt and the Republican-led legislature, which passed it in the final hour of its final day of the 2007 session over the objections of some Democrats, who had wanted the bill to reverse all of the 2005 Medicaid cuts.

After reducing services and tightening eligibility, Missouri’s Medicaid program for the poor fell from a peak enrollment of 1 million two years ago to about 825,000.

Although widening coverage somewhat, this year’s legislation focused on changing the way Medicaid services are delivered. Each enrollee in the renamed “MO HealthNet” program is to undergo a health risk assessment to try to catch problems before they become serious.

Blunt said the new system would provide a better quality of life, partly by focusing on prevention, and would be more sustainable for taxpayers. He said “tens of thousands” of people will be part of HealthNet who were never in the old Medicaid system.

“A lot of people said we need to go back to how we used to do it,” Blunt said after signing the bill in his hometown of Springfield. “How we used to do it was bankrupting the state and failing to provide high quality care, and that’s why we’ve totally changed the system.”

Under the bill, the Department of Social Services is to work with an oversight committee to create several health plans with varying levels of coordinated care. All participants would be enrolled in one of those options, dubbed health improvement plans, by 2011.

By next summer, the department also is to come up with a four-year plan to increase payments for doctors and others Medicaid providers. Certain health care providers could get even more money if they have good patient outcomes, one of the key points pushed by Blunt.

Health coverage would be expanded by:

n Restoring dental and eye care benefits — but not podiatry or orthopedic services — to adults whose benefits were cut two years ago.

n Providing pelvic exams, cancer screenings and family planning services to an estimated 82,500 lower-income women age 18 and older who lack employer-sponsored health insurance.

n Restoring or improving health coverage to a few thousand working disabled residents whose benefits were cut in 2005.

n Expanding coverage to several thousand children of lower-income parents.

n Extending benefits for foster children up to age 21, instead of 18.

Besides Springfield, Blunt also was holding bill signing ceremonies today in Kansas City, St. Joseph, St. Louis and Sikeston.

Blunt’s opponents were countering with their own news conferences in Springfield, Kansas City, St. Louis and Columbia. Their main contention is that the bill does not restore Medicaid coverage to all who lost it in 2005, such as the low-income parents whose income-eligibility threshold was tightened to one of toughest in nation.

“It’s not real health care reform,” said Greg Shufeldt, political director for the Missouri Progressive Vote Coalition, which organized the opposing events. “It makes the 2005 cuts permanent.”

House Minority Leader Jeff Harris, D-Columbia, said the bill amounts to little more than a new name for the program that still will not help as many Missourians as it should.

“At first glance it may look nice, but close examination exposes it for the false reform it is,” Harris said in a written statement.

Among other provisions, the bill lets whistle-blowers get a 10 percent cut for reporting Medicaid provider fraud to the state attorney general’s office, if their tips lead to successful prosecutions.

It also sets up a pilot project in an urban and rural area to offset part of the private health insurance premiums of previously uninsured small business employees. Blunt had originally proposed to implement that insurance provision statewide.

The health care bill is SB577.

Associated Press Writer Marcus Kabel contributed to this report from Springfield.

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