JEFFERSON CITY — One in six Missouri residents are covered by Medicaid, according to a 2019 study by the Missouri Foundation for Health. That’s roughly over 1 million people who rely on the program for health insurance, but some of those people’s coverage could be in jeopardy because of a new Senate bill.  

On Wednesday, Sen. Tony Luetkemeyer, R-Parksville, proposed SJR 60 to the Senate Health and Pension Committee. The bill would ask voters to approve a constitutional amendment that would make changes to the eligibility rules for Medicaid and other health insurance in Missouri. 

The bill would do a number of things:

It would prohibit health benefit plans from refusing to cover someone based on a preexisting condition such as a heart condition or cancer. This portion of the bill would apply to all insurance plans, not just Medicaid.

Also, it would not allow the state to use general revenue funds to reimburse Medicaid or other health insurance companies for any medical assistance given to non-Missouri residents. 

Lastly, it would require able-bodied adults on Medicaid in Missouri to meet work and community engagement requirements. Specifically, these adults would have to do a combination of 80 hours of work, education, job search, child care or volunteer services each month to qualify for coverage.  

Luetkemeyer said this work requirement would help Missourians get to a place where they don’t even need Medicaid. 

“It’s time we offer a hand up, not a hand out,” he said. 

The bill would exempt parents with young children, adults with disabilities or certain conditions and adults who are the primary caregiver of a dependent adult from the work requirement.  

Those in favor of the bill said it ensures that Medicaid funding goes to those who need it most: persons with disabilities, children and other vulnerable populations.  

“Every dollar spent on an able-bodied adult is a dollar that doesn’t go to people who need it,” said Gregg Pfister, a senior fellow with the Opportunity Solutions Project, which has opposed Medicaid expansion in other states. 

There were many people present, however, who had concerns with the bill. 

Health organizations such as the American Cancer Society Cancer Action Network, the American Heart Association and the National Multiple Sclerosis Society shared concerns that the bill doesn't include other aspects of federal law that protect those with preexisting conditions, though it does mandate that people couldn't be denied health insurance because of a preexisting condition.

“This legislation, the way it's drafted, I believe it would say you couldn’t deny coverage to someone with a preexisting condition, but there is nothing that would prevent insurers from charging someone with a preexisting condition a significantly higher premium,” said Emily Kalmer, from the American Cancer Society Cancer Action Network. 

Others said that because courts have ruled work requirements for Medicaid unconstitutional in other states like Kentucky, Arkansas and New Hampshire, it would be a waste of taxpayer money to try to implement the same thing here only to have it struck down in court. 

“Are we going to throw good money down the drain?” said Geoffrey Oliver, from the Legal Services of Eastern Missouri. “If it’s just going to be overturned, is that good policy?”

  • Mark Horvit is the state government editor. Call me at 817-726-1621 with story ideas, tips or complaints.

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