JEFFERSON CITY - Although Republican legislative leaders have issued statements attacking Medicaid expansion, one of their key committees has scheduled two days of hearings on a plan that would expand Medicaid as well as making fundamental changes to the Medicaid system -- suggesting the idea of Medicaid expansion is not yet dead in Missouri's Capitol.
So far this session, Republicans have defeated two Medicaid expansion bills pushed by Democratic lawmakers in committee. House Minority Floor Leader, Jake Hummel, D-St. Louis City, sponsored a bill that would expand Medicaid eligibility coverage to 138 percent of the federal poverty level. This expansion would have put Missouri's Medicaid program in accordance with the federal health care law. At a press conference earlier this session, Hummel said he believes Medicaid expansion is the most important issue in the state. Hummel's bill, however, was killed in the House Government Oversight and Accountability committee.
A similar bill, sponsored by Sen. Paul LeVota, D-Independence was defeated in the Senate Appropriations Committee by a vote of 8-3 along party lines. Sen. Jamilah Nasheed, D-St. Louis City, is sponsoring similar legislation but her bill has yet to be heard in committee.
Even though Republicans have defeated Democratic-backed measures twice so far, one Republican is sponsoring legislation that would address eligibility for the state's Medicaid program. Rep. Jay Barnes' bill would transform the Medicaid systems as well as expand it. In February, Barnes, R-Jefferson City, said he believes Medicaid expansion as prescribed by the federal law is not the way to go and transformation of the system is a better alternative.
Barnes' bill would cut a large number of children from the program and expand Medicaid eligibility, but not to the extent set by the federal law. His bill would also offer an annual cash incentive to encourage Medicaid recipients to keep their health care costs low.
Gov. Jay Nixon has been traveling around the state touting the importance of Medicaid expansion. Nixon has said the expansion would provide health care to an additional 300,000 people and add 24,000 jobs.
"Strengthening Medicaid will strengthen our economy," Nixon said during his annual State of the State address.
Whichever way Missouri lawmakers choose to address the state's Medicaid program, they are wading into an already complicated system. Missouri has had a Medicaid program since 1965 when it was enacted through an amendment to the Social Security Act. The program was designed to offer long-term care to low income citizens of the state.
According to the Department of Social Services, Missouri's current Medicaid program:
|Family Size||Income Limit|
|Children under age 1||185% of federal poverty level (FPL)|
|Ages 1-5||133% FPL|
|Ages 6-18||100% FPL|