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Medicaid expansion nears Carnahan's desk

May 13, 1998
By: Brent P. Johnson
State Capital Bureau

JEFFERSON CITY - An expansion of Medicaid coverage using $56 million of federal payments and $20 million of matching state funds inched closer to Gov. Mel Carnahan's desk Wendesday.

The Senate passed 26-8 the conference committee substitute that altered the level of required premiums and co-payments in the bill. House sponsor Rep. Scott Lakin, D-Kansas City, said he hopes to bring the committee substitute up for debate today.

The bill would expand Medicaid eligibility to families earning up to three times the federal poverty level--$49,350 for a family of four--in order to reach approximately 90,000 of the estimated 175,000 uninsured children up to age 19 in Missouri. These children most often are not covered by insurance because their parents do not currently qualify for Medicaid, do not earn enough to afford private insurance or do not receive it through their employers.

Republican resistance has portrayed such an expansion as providing welfare for the middle class. Some stressed Wednesday that the committee substitute reflected their filibustering efforts against widely increasing entitlements.

"We've moved the consensus on this bill to the right," said Marvin Singleton, R-Seneca.

"This is not the grand state entitlement (Gov. Carnahan) envisioned, which would've been one of the most liberal in the country," said Peter Kinder, R-Cape Girardeau.

Sen. Ed Quick, D-Liberty, who sponsored the bill, said it expands access to affordable insurance not welfare. He congratulated the Senate for putting children above politics.

The committee compromise focused on restrictions for families earning between 226 percent of the poverty level--$37,013 for a family of four--and 300 percent. To qualify, such families could not have access to health insurance premiums costing up to one-third more than the monthly premiums available to state employees under the state's health care plan. Ron Meyer, executive director for Missouri Consolidated, estimates this premium to be $65.

Families earning between 226 and 300 percent of the poverty level would also be required to pay $10 co-payments on office visits. Children would have to wait 30 days before becoming eligible for coverage and another six months if monthly premium payments or co-payments were not made.