Show Me Health Care to replace Insure Missouri for 2009 session

JEFFERSON CITY - Larry Stephens found out he had lost his Medicaid when he went to get his motorized wheelchair fixed.

"My friend works at the store, and she went to go pull up my information in the computer. Then she just tells me, 'Larry, your Medicaid is inactive,'" Larry said.

It wasn't until his caseworker called him that he realized it was no mistake.

Gov. Matt Blunt's 2005 Medicaid cuts took 94,850 off Missouri's Medicaid program. These cuts left another 300,000 with only partial coverage, according to the Department of Social Services.

The 2008 Missouri legislative session saw the introduction of Insure Missouri, a program that would have provided health insurance to an estimated 200,000 people. But the legislation was ultimately held up due to disagreements over portions of the bill that dealt with hospital expansion.

The Senate passed the health care expansion bill, but it got stalled in the House where the committee chairman -- a physician -- demanded that the proposal include provisions to ease restrictions on hospital and medical facility expansion.

The real challenge for the 2009 legislative session, however, may not be certificate of need reform, but instead the budget shortfall.

The budget adviser for Missouri's incoming governor has projected that in the current fiscal year that ends June 30, 2009, the state will face a $342 million shortfall -- meaning the current state budget provides $342 million more than the state will have available to spend.

Senator Tom Dempsey, R-St. Charles County, the sponsor of last session's health care plan, said that tough economic times makes social welfare legislation even more costly.

"Even without changing the eligibility requirements, more people will qualify for Medicaid because more people are unemployed," Dempsey said.

The economy and budget have also affected a few other aspects of the bill. This upcoming year's legislation will be called Show Me Health Care rather than Insure Missouri. Dempsey said that although last year's legislation will be a starting point for the new bill, he wanted to address the concerns of those who saw it as Gov. Matt Blunt's plan. He said when creating the bill they took a look at models from several states, but called it Insure Missouri as "a concession to the administration."

Rather than package all the ideas in one bill, the insurance part will be in one bill packaged as Show Me Health Care, while other aspects from last year's bill will be filed separately. Bills on making medical records available electronically, tax credits for home modification for seniors and the disabled, and portability aspects to help those who lost their jobs carry their insurance, among others, will all be separate pieces of legislation. Dempsey said in touch economic times this will give some health issues a better chance of being enacted into law, even if the larger Show Me Health Care bill does not.

Dempsey is also working with the Missouri Foundation for Health as an additional funding source for the bill.

Rep. Rob Schaaf, R-St. Joseph, refused to bring the bill to the floor last session without addressing legislation that would change Certificate of Need laws. Schaaf said should the Show Me Health Care come his way again without Certificate of Need reform, he's sticking by his principles. Schaaf said he believes free market competition is the best way to keep hospital bills down. "Under Sen. Dempsey's bill from last year the tax payer would be paying twice, which I would still be opposed to because I think it's wrong.