The Missouri Senate and the inconvenient poor

03/27/2014 2:21 PM

04/05/2014 5:28 PM

Republicans in the Missouri Senate came back from spring break with a harsh message for anyone holding out hope for Medicaid expansion: Nothing to see here. Move on.

Sen. John Lamping of St. Louis County, apparently piqued because people won’t quit bothering him and his colleagues about health care for the poor, conducted a question-and-answer session with like-minded opponents on the Senate floor.

“There is no path for Medicaid expansion to occur in Missouri this year,” declared Brad Lager, from Savanna.

“Why is this somehow our problem?” asked Kurt Schaefer, from Columbia.

“This is done,” said Lamping. “It’s not happening. Go find something else to do.”

Go find something else to do.

OK, but what?

Thanks to brutal cuts imposed by the Republican-controlled General Assembly and then-Gov. Matt Blunt in 2005, Missouri has one of the nation’s most restrictive Medicaid programs. Working parents can make no more than 19 percent of the federal poverty level to qualify; that’s about $4,000 a year for a family of four. Childless adults aren’t eligible at all.

The Affordable Care Act had intended for people who make up to 138 percent of the poverty level to be covered by Medicaid. But a U.S. Supreme Court decision made that optional for states.

That leaves almost 300,000 people in Missouri who make too much to qualify for Medicaid but too little to receive subsidized insurance through the insurance exchange.

Some of them have visited the Capitol, where the House is actually holding hearings on a bill that would reform and expand Medicaid.

Lawmakers heard this week from Jamie Kanan of Potosi, a mother of five who works full-time in home health care plus a side job. She needs surgery for back pain and leg numbness but can’t afford insurance and can’t pay for the care without it.

They heard from a Kansas City man, Todd Foltz, who had to give up his job and employer-provided health insurance when his multiple sclerosis became too disabling, and who now struggles to pay for medicines.

Lamping and the other Medicaid detractors had nothing to say about these people during their pseudo “debate” this week.

No. They talked about how Missouri can’t afford to expand Medicaid, even though credible studies have shown that it can, even after the federal government would require the state to pick up 10 percent of the share in two years. The cost would be offset by savings in programs that the state now funds, such as mental health treatment.

They said rural hospitals were struggling not because too few people have insurance but because the hospitals, like their patients, are too dependent on subsidies.

They griped about how Democratic Gov. Jay Nixon waited until after he was re-elected to announce his support for Medicaid expansion.

Go find something else to do


That might work for the governor. And the Missouri Chamber of Commerce and Missouri Hospital Association. And the churches and other groups which support expansion.

But it’s heartless advice for the waitress who needs a knee replacement. Or the child care worker postponing surgery for a painful ovarian cyst. Or the medical office receptionist forced off her job by a debilitating case of lupus.

These are the stories of real people I’ve talked to over the last couple of years. All they can do is continue to struggle. They’re not going away, and we’re not going to stop talking about them. And if Lamping and his friends find that inconvenient, that’s just too bad.


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