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March 29, 2005
Dear Governor and Members of the Missouri General Assembly,
At this time in the history of our state, Missouri government faces a serious fiscal crisis. There is insufficient revenue to fund all of the services currently provided. We note that in order to meet the constitutional obligation to balance the state budget the Governor recommends major reductions in Medicaid as well as funding cuts in many other human services, such as community-based services for the mentally ill and those with disabilities and mental retardation.
In a time of fiscal crisis all are called upon to sacrifice. In our view no department or area of state government should be exempt from the funding cuts necessary to balance the budget. We urge you to look at the budget globally, comparing priorities across state department lines. In the current fiscal crisis good stewardship in one area will save dollars for critical services in another.
We urge you to give first attention to promoting respect for the inalienable dignity of every human life from the moment of conception or inception to the moment of natural death. In this regard, we are grateful that the proposed state budget funds the alternatives to abortion program and provides health coverage for pregnant women up to 185% of the federal poverty level.Missouri’s largest drop in abortion numbers since the 1972 Roe v. Wade decision occurred after the legislature expanded Medicaid coverage for pregnant women from 133% to 185% of the federal poverty level. We understand legislation (SB 539) has passed the Missouri Senate that would repeal the state’s legal obligation to provide this expanded coverage. This means that a future legislature could abandon its commitment in this area. We strongly urge you to reconsider this decision. This expanded coverage for pregnant women is an effective way to protect the health of both women and their unborn children and to reduce abortions in our state.
We urge you to give priority attention to the very poor, the frail elderly, those with disabilities and others who need assistance to lead a life of dignity. The Gospel calls us to have a special solicitude for the least among us. We are encouraged by the recommendations of the House Appropriations Committee for Health, Mental Health and Social Services to restore funds for community-based services for the mentally ill and those with disabilities. We also commend the committee for restoring some of the health coverage provided to the elderly and permanently disabled. However, we are deeply troubled by legislation (SB 539) approved by the Missouri Senate that would end Missouri’s Medicaid program by June 30, 2008. We understand this legislation also proposes to create a commission to study how to design a new Medicaid program. We certainly support evaluation of how to improve the delivery of health care to our most vulnerable citizens. However, if the legislature fails to act on the commission’s recommendations, then the Medicaid program will end with no replacement thereby jeopardizing the health of thousands of needy Missourians.
Medicaid costs have risen rapidly in recent years. As employers providing health coverage, we appreciate the fiscal challenges of rising health care costs. This problem is not unique to Medicaid, but is present throughout the health care industry. Ultimately, there is a need to better manage health care costs. It is difficult for both private and public payers of health care to provide health coverage without a more effective policy to control costs.
As we write to you there remain under consideration funding cuts that we find very troubling. It is proposed to cut health coverage for parents from seventy-five percent of the federal poverty level to thirty percent. A mother with two children earning as little as $4,705 annually would no longer qualify. There is a proposal to remove the requirement in state law to provide certain medical services, such as hospice care for the dying, wheelchairs for the lame, and eyeglasses for those who need them. There is consideration of moving many people with serious disabilities and mental illness out of state facilities and placing them in community based programs, which may not be prepared to receive them.
We urge you to be open to all reasonable ideas concerning how best to balance the state budget while assuring the welfare of Missouri’s citizens. This would include giving consideration not only to funding cuts but also to additional revenue to fund essential services.
We urge you to work together to promote the common good of Missouri and to consider especially the needs of Missouri’s most vulnerable citizens. In closing, please know that you are in our prayers as you seek to develop this year’s Missouri state budget.
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