Missouri Senate on Medicaid expansion: Go find something else to do

03/25/2014 5:46 PM

03/25/2014 5:46 PM

The Missouri Capitol is often filled with people urging lawmakers to expand the state’s Medicaid eligibility limits. They come from businesses, hospitals, churches and their homes.

Some, like

Todd Foltz

, are in the gap which the General Assembly created when it refused last year to increase eligibility. Foltz, who lost his job and his employer-provided insurance because he has multiple scleroris, is one of about 250,000 Missourians who earn too much to qualify for Medicaid but too little to be eligible for a subsidized policy in the new insurance exchange.

“For me, it’s becoming not just a gap but a crevasse, and it’s becoming not just frightening but terrifying,” Foltz said this week.

That was at a hearing in a House committee. Some House members from both parties want to do something to correct an unjust situation.

But a few hours later, Republicans in the Senate sent Foltz and other Medicaid supporters a harsh message: Nothing to see here. Move on.

Or, as Sen. John Lamping of St. Louis County put it: “This is done. It’s not happening. Go find something else to do.”

I assume Lamping was directing his remarks to other legislators. But he was indirectly speaking to people like Foltz, who, because he is too sick to work, is too poor to get consistent, adequate medical care.

Go find something else to do.

Perhaps Lamping could explain to Foltz exactly what he thinks he should do.

To qualify for Medicaid in Missouri, a parent can make no more than 19 percent of the federal poverty level, about $4,000 a year for a family of four. Childless adults aren’t eligible at all.

People below the poverty line of $11,490 for an individual and $15,510 for a couple aren’t eligible to get help through the insurance exchange set up in the Affordable Care Act.

Four GOP senators along with Lamping declared that Medicaid expansion is a non-starter, even though Republican lawmakers in the House have presented some creative ideas about improving the program at the same time. That’s a deep bench for a filibuster.

Whatever their opposition is based on, it isn’t common sense, or honest evaluation of data. Multiple studies have shown that, with the federal money that would be available, Missouri could afford to expand Medicaid to the threshold called for in the Affordable Care Act. And the anticipated economic benefits from an expanded health care network would be a gain for the state.

Eventually Missouri, Kansas and the other holdout states will expand Medicaid. The successes of states that are doing so now will leave lawmakers with no choice. But the early resistance is costing millions.

The federal government will fully fund the costs of the expansion for three years, starting this year. If the legislature won’t act this session, it will forfeit two years of 100 percent reimbursement. After the third year, states will begin picking up a portion of the cost, up to 10 percent.

Go find something else to do. That would be good advice for Republicans in Congress who have voted to repeal the Affordable Care Act 50-plus times already. That’s not happening, either, but I’m pretty sure Lamping is fully supportive of the efforts.


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