Missed Opportunities on Medicaid Reform

State lawmakers missed an opportunity this year to reform and expand Medicaid so that the program would better reflect Missouri values and concerns for the poor. State Representative Noel Torpey (R-Independence City) and State Senator Ryan Silvey (R-Kansas City) tried to convince lawmakers of the need to take action but Medicaid legislation ultimately failed to pass in either chamber of the Missouri General Assembly.

With the passage of the Affordable Care Act (ACA), states have the opportunity to expand Medicaid to provide health coverage to more of the working poor. Under ACA the federal government pays for 100% of the expansion for three years and 90% from then on. In responding to concerns that the federal government would renege in its financial commitment, the bills made the federal funding mandatory for Missouri’s entry or continued participation in the Medicaid expansion.

Representative Torpey and Senator Silvey also sought comprehensive reforms in Medicaid. The reforms would have required more personal responsibility from recipients, such as making co-pays for medical services, offered incentives for the adoption of healthier habits, such as limiting tobacco use, and encouraged recipients to establish health saving accounts to manage their health purchases.

The MCC supported both Medicaid reform and expansion, noting that health care involved both rights and duties for individuals and families. In a letter to all state legislators, the MCC declared:

“Each person as a creature of God has a right to basic healthcare; at the same time, individuals and families are called to care for their own health. Properly structured, Medicaid reform will place as much responsibility on individuals as is reasonable, but recognize when people need assistance from others.”

The MCC repeatedly stressed that expanding Medicaid should include reforms so Missouri could create its own version of the program, including strong anti-abortion provisions. But for many the Medicaid legislation seemed too tied to the Affordable Care Act (Obamacare), which is very unpopular in many areas of Missouri.

States can decide to participate in Medicaid expansion at any time so the issue is likely to be revisited in the 2015 session of the Missouri General Assembly.


Posted: May 16, 2014

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