Medicaid reform heads to the House

JEFFERSON CITY - The House has five weeks left to pass legislation to restructure Medicaid. If it doesn't, the June 2008 expiration date for the program would force legislators next year to come up with a two-thirds vote for a "emergency clause" to prevent the program from expiring.

The sunset provision, which dissolves the Medicaid program, was added to the statue in 2005 along with Medicaid eligibility cuts. Missouri law states that any legislation that is passed during a session will not take effect until August 28 of the same legislative year. The only way around that delay in the effective date for a law is with a two-thirds vote of the House and Senate for an emergency clause.

Without an emergency clause, any restructuring of Medicaid next year would not take effect until after the program had expired.

House Republican Leader Tom Dempsey, R-St. Charles, said that because of the sunset provision this issue is a priority for the House and he thinks there is enough time left in the session to pass the bill.

"We're going to make sure that there is a health care safety net for what is the Medicaid program now," he said. "We're definitely going to find time for that on the floor."

Rep. Robert Schaaf, R-St. Joseph, the chair of the House committee the bill was assigned to, said that he will probably take up the bill next week. He said that four weeks is "way more than enough time" to pass the bill.

"We're just going to work diligently until we get the job done," Schaaf said. "And I believe that there's enough time in the session to get this bill passed."

The bill's sponsor, Sen. Charlie Shields, R-St. Joseph, also said that he is "very confident" that there is enough time left and "pretty confident" that there are enough votes in the House to pass the bill.

But House minority floor leader, Jeff Harris, D-Columbia, said that he is against the legislation, which was pushed by Gov. Matt Blunt in his State of the State address. Harris said that he intends to vote against the bill when it comes to the House floor.

"The governor's scheme is inadequate because it doesn't restore health care for the senior citizens, the persons with disabilities, the kids and the working families whose health care he cut two years ago," he said.

Schaaf said he is not completely happy with the bill as it is, and that it will face some changes in committee and possibly on the House floor. Schaaf, who is a family physician, said that he wants to add a provision to increase the reimbursement rates for physicians who see Medicaid patients.

"One of the big problems has been access -- providers not participating in the program," he said. "And the biggest problem there is reimbursement and I think we have to address that issue. If we don't fix the biggest problem with the program now, how can we call reform a success?"

Shields said that he would be supportive of such a change.

"It's an issue that we're starting to see more and more providers drop out of Medicaid because of reimbursement rates," he said. "So obviously it's something that we need to address."

Schaaf said that the changes will not affect the likelihood of the bill's passage.

"Of course," it will pass, he said. "We're going to put forward something that we feel comfortable will pass the House."