House stops short of reviving Medicaid transformation, approves "mini-Medicaid"
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House stops short of reviving Medicaid transformation, approves "mini-Medicaid"

Date: April 24, 2013
By: Meghan Boggess
State Capitol Bureau
Links: HB 986 HB 700

JEFFERSON CITY - Despite saying last week that his legislation to reform Missouri's Medicaid system was dead, the Republican sponsor of the legislation appeared to make an attempt Wednesday to revive the bill before he ultimately dropped the issue.

Rep. Jay Barnes sponsored a bill that would reform the state's Medicaid system, including expanding eligibility to 100 percent of the federal poverty level while reducing eligibility for pregnant women and the State Children's Health Insurance Program. He admitted last week that the legislation had no chance of passing the General Assembly this year after Senate leadership declared the issue "dead."

Senate Republican Floor Leader Ron Richard, R-Joplin, previously said Barnes' original legislation would not pass in the Senate this year. Instead, Richard said the conversation over expanding Medicaid would continue next year.

Barnes, R-Jefferson City, offered an alternative to Medicaid reform on the House floor Wednesday, which he dubbed "mini-Medicaid." The House gave preliminary approval to the bill, which includes four aspects of Barnes' original reform legislation. The bill would expand the Ticket to Work disability welfare program, simplify the Medicaid enrollment process, raise the age for foster care children to be eligible for Medicaid to 26 and create a joint interim committee.

The interim committee would be tasked with evaluating Missouri's Medicaid system and formulating an idea of what it should look like in the near future.

"Maybe we can talk with the Senate and get serious about giving Missouri the most market-based Medicaid system in the entire country," Barnes said.

Before the House approved the legislation, however, Barnes offered an amendment to the bill that would have included the provisions of his original Medicaid reform bill.

Barnes said his legislation could make Missouri a national leader in forming legislation in the wake of the Affordable Care Act.

"This is a game changer. It changes the entire nature of Medicaid. We structure it so that price matters, so that we get away from a system with runaway spending," Barnes said. "It could be a model for the entire country on how to remake Medicaid in a way that could save literally tens of billions of dollars if implemented nationwide."

Barnes ultimately withdrew the language from the "mini-Medicaid" bill, citing the Senate's stated refusal to pass any legislation regarding the expansion of Medicaid.

"Rather than figuring out how we can make the best out of a bad situation, they are ceding the field for another year," Barnes said.

Backing out of Medicaid reform would not be a "winning strategy for anyone," Barnes said, adding that doing nothing to transform the state's system would mean giving Missouri's control over its health care to the federal government.

Rep. Chris Molendorp, R-Jackson County, spoke in support of reviving Medicaid reform, citing the changing nature of health care in the United States.

"The model has changed, the world has changed," Molendorp said. "We have an opportunity now to save money, reform a system and add uninsured people to the rolls. It is very rare we are in this building when you are presented with a win-win."  

The "mini-Medicaid" bill gained preliminary approval but requires one more affirmative vote before it can move to the Senate.

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