State lawmakers working on plans for Medicaid expansion

Posted October 3, 2013 at 11:50 am

by Christine Roto

A bipartisan group of Missouri lawmakers is crafting a proposal to expand the state’s Medicaid program that would potentially give thousands of Missourians access to the health care program.

Last year, the Republican-led legislature rejected Democratic Gov. Jay Nixon’s proposal to expand the program using federal funds from the Affordable Care Act. Republicans cited concerns that the federal government would not keep its funding promises, leaving the state with a giant Medicaid bill.

But, during the House committee hearing on Sept. 26, Republican members voiced support for plans that might tie Medicaid expansion to changes in the program to require greater responsibility for recipients and potentially privatize the program.

The panel’s chairman, Rep. Jay Barnes, R-Jefferson City, gave the bipartisan group until Oct. 15 to craft legislation that would expand coverage, crack down on fraud and abuse and implement incentives for healthier lifestyles.

The group heard testimony on Sept. 26 about what other states, including Arkansas, Indiana and Iowa, have done with their Medicaid programs and considered the possibility of seeking federal waivers to make changes to the state’s existing program.

“There are options for states to pick and choose a Medicaid program they want,” said Sidney Watson, St. Louis University law professor. “Every state looks different so they have the ability to pick different plans.”

Under the Affordable Care Act, states can expand their existing Medicaid programs to provide coverage for people with incomes up to 138 percent of the federal poverty line. The federal government would pick up the tab for three years and then the state would gradually pay up to 10 percent of the expanded program’s cost.

Feds release health care exchange estimates, Missouri’s options limited By Taylor Beck

A report released on Sept. 25 by the federal government showed that Missourians will have fewer options in the new online marketplace for health insurance than other states.

Because state lawmakers declined to create a state health exchange, the federal government will operate Missouri’s online insurance marketplace. Missouri voters also approved a ballot measure in 2012 that prevents the governor of any state agency from creating an exchange without legislative approval.

Thirty-five other states will also allow the federal government to run the health insurance exchanges, but Missouri might have some of the fewest policy choices.

Missourians on average will be able to choose among 17 qualified health plans, which is below the average of 53 choices for states not running their own exchanges.

The report also estimated how much insurance would cost on the marketplace, which launched on Oct. 1.

The federal Department of Health and Human Services created the report, estimating a family of four on a $50,000 a year income would pay $798 a month on average for the “second-lowest-cost silver plan.” After a federal tax credit, though, that price could drop to $282.