It may yet turn out to be the saving grace for a badly wounded Medicaid program that no longer provides health coverage for thousands of Missouri’s poor, elderly and disabled. When lawmakers passed legislation authorizing many of the Medicaid cutbacks now taking place, they accepted very few amendments, but one they did adopt established a Medicaid Reform Commission to consider a new and supposedly improved program for Missouri’s medically indigent.

Throughout the summer and now into the fall the commission has been taking testimony from citizens on how Medicaid should be re-structured. commission members have gotten an earful, including biting criticism for Medicaid cuts that will result in the loss of health coverage for 78,426 adults and thousands of elderly and disabled citizens.

But the commission has also learned about problems in Medicaid, such as how too many recipients visit emergency rooms for non-emergency care when public clinics are nearby. Doctors have claimed that Medicaid reimbursements are too low and that is why many doctors and dentists won’t accept Medicaid patients. Managed care companies have explained how the state of Missouri could save money by moving from a “fee for service” approach to more managed care.
At the commission’s first meeting, Senator Michael Gibbons, the President Pro Tem of the Missouri Senate, challenged commission members to “wipe the slate clean” and not worry about current federal law parameters for how Medicaid is delivered. He urged the commission to think in new and creative ways about how to structure the delivery of health care to Missourians.

The Missouri Catholic Conference has taken Senator Gibbons at his word. The MCC recently submitted testimony to the commission calling for new thinking so that all Missourians have access to affordable health care. Entitled “Beyond Medicaid – Creating Access to Health Care,” the MCC’s testimony recommends a five point strategy:

1. Expand the availability of affordable private health insurance, with special efforts to encourage employers to offer health benefits;

2. Cooperate with the federal government to control the skyrocketing costs of health care;

3. Encourage more effective and coordinated use of local resources of health care providers to serve the poor and uninsured.

4. Reform Medicaid by requiring better stewardship of taxpayer money and assuring health coverage for families and individuals who cannot afford private insurance.

5. In all state initiatives related to health care, place a greater emphasis on promoting healthy lifestyles among citizens and providing preventive health care.

The MCC testimony calls for responsibility at all levels of society, beginning with individuals, who have an obligation to care for their own health and parents, who are responsible for the health and well-being of their children. When people cannot access affordable health, then the larger community has a moral obligation to provide assistance, according to the MCC testimony.

Government can assure access to health care in a number of ways, the testimony explains, including providing incentives for private sector responses. The MCC urges the commission to consider providing tax credits to small businesses that begin to offer health benefits to employees.

To encourage personal responsibility in health care, the MCC testimony expresses support for co-pays or other forms of cost-sharing by Medicaid recipients. The testimony also states that “In general, the state of Missouri should honor the dignity of work and workers by restoring health coverage for the working poor.”

Recognizing the need to make Medicaid more cost effective, the MCC urges greater efforts to root out fraud, especially by providers who over-bill and use other fraudulent practices to raid the public treasury.

A complete copy of the MCC testimony can be found here.