Amendments keep Insure Missouri in the Senate

JEFFERSON CITY - The Senate Insure Missouri bill got its first taste of floor debate Tuesday as senators debated several amendments with just over three weeks left in legislative session.

Insure Missouri would provide insurance to an estimated 200,000 Missourians of the 719,000 estimated uninsured.

Some of the amendments presented only minor changes, tightening up language and providing clearer definitions. Although amendments are a typical part of the process, there are only three and a half weeks left of legislative session, making time a critical factor and amendments a lengthy process.

Sen. Joan Bray, D-St. Louis County, was critical of a bill that she said gives too much power to the insurance industry.

Bray, not a fan of the insurance model employed by the bill, said she would rather see money spent on health care rather than health insurance.

"I want to pay for services, not for insurance," said Bray, a proponent of Medicaid.

Bray has withdrawn an amendment that would have restored Medicaid coverage to 100,000 Missourians who lost it in 2005, an amendment Charlie Shields, R-St. Joseph, said was not affordable for the state.

Though she said she will not support the bill, "were it to pass, I've got amendments to make it not such an onerous law," said Bray. She continued, "A lot of people are saying this bill is better than nothing, but I'm not sure it is.

"There is so much focus on insurance rather than health care," Bray said, adding she has two more amendments on the way.

Other attempts to change the bill were more successful.

One change that was adopted was an amendment that would increase the advisory board portion of the bill to include an optometrist, a nurse and a mental health professional as well as language to ensure that more representatives will be from rural areas. The amendment will bring the total membership of the advisory board from 18 to 29.

Sen. Wes Shoemyer, D-Clarence, said the size of the commission won't be a problem as it still has to report to the executive board.

"You want it to be big. Let everyone have their say and be represented, then hand it over to the executive who gets to pull the trigger," said Shoemyer, who said he also has a couple more amendments he plans to file.

Another adopted amendment would create the Commission for Tobacco Use, Prevention, Cessation and Enforcement, which would also include a number of representatives that would have the responsibility of designating some funds.

Other amendments included one to provide more information to parents regarding HPV, providing rehabilitation for those with brain injury, requiring insurance companies to cover distance diagnosis, such as those via television, and allowing nurses to prescribe medication.

Although he said the bill is not perfect, Shoemyer said he will most likely support the bill.

"It expands coverage for Missourians," he said. "Is it the perfect way I dreamed of it being offered? Not really. But I don't want to vote against something that would expand coverage."

Despite the short time left in session, Shields said he thinks there is enough time to get it passed in the Senate and enacted into law, even with all the amendments still on the way. "We'll just work through them. It's part of the legislative process."