At southwest Missouri Medicaid panel, public voices against expansion silent

SPRINGFIELD, Mo. — Medicaid recipients in southwest Missouri presented a clear message to a panel of lawmakers and citizens Tuesday: Don’t cut Medicaid for those who already have it.

At a hearing of the General Assembly’s working group tasked with exploring how to move forward with expansion and reform of the state administered federally funded health care program for the poor, a handful of recepients testified about how the program has helped them.

Charolette Thornberry, an elderly resident of Springfield, testified that being on Medicaid saved her life. She was diagnosed with a series of conditions and nearly died, but after enrolling in the program, was able to access some 31 drugs she takes daily and home health aid.

“Because of Medicaid, I got out on my own,” she said. “If it wasn’t for Medicaid, I would probably be dead.”

State Rep. Noel Torpey, a Kansas City area Republican tasked with chairing the House working group, said he had not before heard from the perspective of Missourians who fear they might lose benefits as lawmakers consider “transformation” of the program.

“As a representative, I haven’t seen it that way, but it is good to have that testimony to hear and we’ll see what happens,” he said. “It is a good perspective to have.”

Torpey, noting it only the second of the working group’s six meetings, said it was “too early” to determine what might be included in the committee’s reccomendation when asked whether Tuesday’s testimony swayed him in any way toward full expansion of the program to those earning up to 138 percent of the poverty level, as called for by the federal health care law.

The committee meeting went on for nearly eight hours, including a nearly two hour presentation from the Missouri Department of Social Services about Medicaid elligiblity in Missouri. Several people left as the afternoon waned on, but nobody who stayed until the end was turned away from testifying.

In Springfield, in the heart of conservative southwest Missouri, nobody testified against Medicaid expansion. Torpey noted that he felt the meeting was very “one sided” in favor of the program and looked forward to the future meetings. He said that “it is interesting now” that after Missourians broadly rejected health care exchanges and other provisions of the federal Affordable Care Act when they were placed on the ballot that there was not a vocal presence in opposition to Medicaid expansion, as called for by the same law.

Currently, Medicaid elligiblity varies widely between the children, pregnant women, disabled individuals, the elderly, and the poor. If the state were to move forward with the federal health care law, the program would be expanded to all Missourians making below 138 percent of the federal poverty level, or just over $32,000 annually for a family of four.

Missouri is one of only a handful of states that allows people to “spend down” some of their income on health care to meet eligibility requirements, representatives from the Missouri Department of Social Services told the committee.

As the state already seeks ways to reduce costs within the Medicaid system, they have started to impliment a new computer program to help enroll individuals in Medicaid. The program requires indivuals to provide personal documents to be scanned into the system and reduces paper records, a step championed by the bill’s supporters as an effort to increase effeciency. With the new computer program, some who testified raised concerns that those applying for Medicaid might either be unable to access a computer or be uncomfortable providing informationn on a public computer, such as at a library.

Along with the new software program, the is already phasing out individual case worker’s for Medicaid in exchange for customer resource and call centers. Bradley Harmon, president of the Missouri State Worker’s Union, said the call center has “not been a helpful change,” and was concerned that a backlog of some 1,500 voicemails a day means some in need of health assitance are not being helped.

“The system we have is understaffed and underresourced,” he said, noting that expansion would provide a “huge lift” to the agencies administering Medicaid expansion.

Last week, at a hearing in Independence, the panel heard that hospitals that cater to those without insurance may be hardest hit if Medicaid is not expanded due to deep cuts in disproportional share payments, which help make up some of the difference for patients who show up in emergency rooms and do not have insurance or cannot afford their bill.

In President Barack Obama’s budget this year, he sought to hold off on implementing the cuts to DSH, but that proposal did not move forward. Nationally, hospitals are lobbying to delay the provision, but in Missouri, hospitals have joined the Missouri Chamber of Commerce and others business groups urging the General Assembly to expand the state’s Medicaid system using federal funds.

Under the plan proposed by Gov. Jay Nixon, Medicaid would be expanded to 300,000 Missourians using federal funds for the first four years, before the federal government ultimately cut back its share to 90 percent in 2020. Currently, nearly 894,000 Missourians are enrolled in the program.