Insure Missouri bill out of committee

JEFFERSON CITY - One of the largest health care expansions in recent memory cleared the Senate Health Committee on Tuesday.

The measure, approved by a unanimous 5-0 vote, would phase in government-financed health care coverage for more than 200,000 Missourians -- at an ultimate projected cost of more than $90 million per year in state funds.

The bill, sponsored by freshman Sen. Tom Dempsey, R- St. Charles County, would provide insurance to an estimated 201,200 by the time of full implementation. Dempsey estimates there currently are 719,000 uninsured Missourians. Legislative staff estimated the original bill with all of its provisions -- and before committee changes -- ultimately would cost more than $94 million per year.

Social Services Department staff estimate it would take six years to phase in the coverage.

Although the legislative session has just a little more than five weeks left, Dempsey said there still is hope for the measure.

If the Senate can pass the bill by next week, "I think I can get it to the House in time to get it to the governor," said Dempsey, adding he thinks he has a 50-50 chance of getting the legislation passed.

Although new this year to the Senate, Dempsey is far from a legislative newbie. Before winning a special election this year, Dempsey had been the GOP leader in the House.

His legislation has received support from the medical community, although each with their own individual set of reservations.

Steadily, though, Dempsey has been working with different groups to address their concerns, and several spokespersons acknowledge progress is being made, issues talked about, language tightened.

However, there are several issues yet to be resolved.

Funding for the plan would come from both the state and federal government -- most from the federal government.

Dempsey acknowledged concern that the federal funding for the program would not be flexible enough for the state should the cost increase. In that case, more money could be needed from taxpayers to cover those that earn above the federal poverty level, which is $17,600 for a family of three.

This is of paramount concern to Dempsey, who said, "I don't want to extend a benefit to someone today and then take it away tomorrow."

The Missouri Budget Project, an advocacy group that analyzes how budget policy affects low income people, expressed concern that the plan still may not be affordable for those earning more than the federal poverty level.

Those earning above the federal poverty level -- up to 225 percent -- would be eligible for coverage, but would be charged for coverage on a sliding scale based on income.

One area of controversy in the bill has been information disclosure concerning both costs and quality of care. It has been an issue that has put hospitals against insurance companies.

In the current version of the ever-evolving bill, there would be a state-mandated Web site that would provide information to the consumer.

"The Web site would be a tool for consumers to see where quality meets price," Dempsey said.

The insurance industries want there to be even more information available to consumers, said David Smith of Blue Cross Blue Shield. Consumers may like this, but it would also be beneficial to the industry.

Sen. Wes Shoemyer, D-Clarence, has raised questions about the bill and how it addresses the uninsurable.

"The way the bill is written right now, it gives coverage to everyone in the high-risk pool. And that would be great," Shoemyer said, "except I don't think this bill means to do that."

Although there are only records of 2,500 uninsurable Missourians, the estimate is anywhere from 12,000 and up.

The bill does change some of the criteria for qualifying for the high-risk pool, including changing the waiting period to qualify from 12 months to six months.

Dempsey's bill is one of several that have been filed in the legislature to expand government-funded health care.