Gov. Eric Greitens hopes $41 million from a legal settlement can restore a cut in his proposed state budget to a program providing in-home care and nursing home services for people with disabilities.
The money comes from a Missouri Supreme Court decision allowing the state to recoup money it was owed, but did not receive, from a 2003 settlement with tobacco companies.
Greitens announced Thursday that he’ll ask legislative budget committtees to use the money to ensure that 20,000 people would not lose state-funded in-home care and nursing home services. The rest of the settlement, $11 million, will go to public schools to help offset his proposed cuts to transportation funding.
“This settlement is good news,” he said in a post on Facebook announcing his budget decision. “But it’s important to remember that they are a lucky break. Sound budgets are not built on lucky breaks. Our budget problems cannot be solved by stopgaps and short-term funding windfalls.”
Greitens’ original budget proposal looked to save millions by requiring people to display more severe disabilities to qualify for state-funded care.
The decision sparked outrage among disability advocates, and Greitens had avoided any questions about how he came to include the in-home care program in his proposed budget cuts.
Earlier this week, Democratic state Sen. Jason Holsman of Kansas City called on Greitens to use the settlement money to restore the program’s funding, saying the money could “prevent 20,000 vulnerable Missourians from losing life changing — and sometimes lifesaving — care they need.”
Cathy Brown, the director of public policy for disability advocate Paraquad, said restoring the funding for the program is the right thing to do.
“When people’s health and independence are at stake and we can avoid forcing them into crisis and shifting costs to hospitals, emergency departments and institutions, we should,” she said. “Moving forward, we hope to be a significant part of the conversation about how to best support people with disabilities in the community in a fiscally responsible way.”
House Budget Chairman Scott Fitzpatrick, a Shell Knob Republican, cautioned against using one-time money to fund an ongoing program, warning that, “If we put it back, we’re going to be faced with the same problem next year.”
Greitens emphasized in his Facebook post that dramatic changes are needed in the state’s Medicaid program.
According to acting state Budget Director Dan Haug, lawmakers budgeted $10.3 billion for Medicaid in the current fiscal year, which ends July 1. The governor’s proposed budget calls for $10.7 billion in Medicaid spending in the next fiscal year.
Medicaid in Missouri covers low-income seniors, people with disabilities, children, pregnant women and very low-income parents — those making less than 19 percent of the federal poverty level, or roughly $4,000 a year for a family of three.
One in six Missourians is on Medicaid, with children making up 63 percent of recipients. But a vast majority of Missouri’s Medicaid costs — roughly 65 percent — comes from care for the disabled and the elderly.
“The simple fact is that if health care spending in Missouri is not reformed,” he said, “it will destroy the budget and threaten every other important program that we care about.”
A bill that would direct the state to seek a waiver from the federal government allowing a dramatic overhaul of Missouri’s Medicaid program is set to be debated in the Missouri Senate in the coming weeks. The intent is to seek a block grant that would provide the state greater flexibility on how to spend federal dollars, but critics say it could compromise the care patients depend on.