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Lots of Talk, Few Votes

February 26, 1998
By: Brent P. Johnson
State Capital Bureau

JEFFERSON CITY -The two biggest health issues of Missouri's 1998 legislative session stalled Wednesday when they hit a wall of Republican-launched amendments.

In the Senate, a bill to extend Medicaid coverage to the estimated 175,000 children in Missouri without health insurance met resistance concerning the levels of required co-payments. Legislation sponsored by Sen. Ed Quick, D-Liberty, would provide such coverage to families living at up to 300 percent of the poverty level by utilizing the estimated $51.6 million of federal money now available after Congress passed the State Children's Health Insurance Program last year.

Similar legislation that established a nonprofit corporation to finance coverage for children using grants and general revenue funds failed at the end of last year's legislative session as a result of a Republican filibuster.

"It would be the tragedy of this session if this failed," said Sen. Joe Maxwell, D-Mexico and Democrat caucus chair.

The bill addresses the health care needs of children whose parents do not qualify for welfare but neither receive the insurance through their employers or earn enough to buy it. "This is not about welfare. It's about providing an opportunity for those children whose parents get up and punch a clock somewhere," Maxwell said.

Republican opposition centers on whether families will drop private insurance to get government insurance and whether benefits extend too far beyond the poverty level. Sen. David Klarich, R-St. Louis County, said he does not want to create another entitlement and that "there's no question" co-payments should be required between 200 and 300 percent of the poverty level.

A family of four at 300 percent of the poverty level operates with a budget of $48,500, said Sen. William Kenney, R-Lee's Summit.

Maxwell called Republican opposition "short-sighted" for not having an alternative to using the federal money than through Medicaid.

In the House, debate on legislation to grant small business employees the option to purchase health insurance through the power of a pool continued for the second day. The Missouri Consolidated Health Coverage Plan, currently available to state employees and employees of local government bodies opting to join it, would be extended to small businesses with fewer than 50 employees under a bill sponsored by Rep. Tim Harlan, D-Columbia.

"I'm very pleased with the support," Harlan said. "Opposition has only come from people with insurance interests."

That opposition has focused on fraudulent businesses being established simply to take advantage of the pool and whether the definition of an active business is too broad.

Harlan said he expects several amendments will be offered today, including proposals to grant tax credits to small businesses offering health coverage to their employees and to expand high-risk pools.

Missouri Consolidated currently covers state and local government employees in separate pools. A third pool of small business employees would be created under the bill. Insurance companies wishing to provide coverage under the plan would be required to bid premiums for all 3 pools, though they would remain separate.

The small business pool would be allowed to "spin off" on its own should a majority of its members elect to do so.

Business associations are split on the issue. The National Federation of Independent Business has supported the bill as an option for its members.

Joe Frappier, president of the Missouri Chamber of Commerce, said he would prefer tax credits to encourage employers to provide health coverage. He said the bill "would destroy choices rather than create additional ones. It's not viable over the long term."