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Insure Missouri alternative debuts: Bill's future unknown at this point
By Alyson E. Raletz/St. Joseph News-Press, Mo.
A new version of Insure Missouri now pumped up with components absent from the governor's plan to expand Medicaid eligibility has checked out of rehab. But the bill's likelihood of making it in the real world or out of the Missouri Legislature is tough to call with five weeks left in the session.
Matt Blunt's first phase of Insure Missouri would have gone online in March, but he yielded to critics, including Rep. Dr. Rob Schaaf, R-St. Joseph, who have been busy crafting a substitute.
That legislation made it out of committee last week, setting it in motion for several more hurdles of debate before it lands in Mr. Blunt's lap.
Dr. Schaaf described Insure Missouri as a market-based program where people have individual health insurance policies purchased by the state.
Anyone between 19 and 64 who is employed, but doesn't have access to employer insurance and earns up to 85 percent of the federal poverty level is eligible for coverage in the plan's first phase. Future phases could bring eligibility up to 225
percent.
Those individuals will be responsible for monthly contributions to their own health savings accounts, which will be used to cover deductibles. Contributions will be based on income.
Despite concerns that families on the lower end will struggle to meet the monthly payments, the Missouri Catholic Conference supported the bill in committee.
"It's a long, complicated bill. It certainly could be improved, but the overall goal is a good one and that is to expand health coverage to the working poor," said Mike Hoey, assistant
director.
Mr. Hoey said the organization preferred Mr. Blunt's version of Insure Missouri because it required less cost-sharing from participants, but he dubbed the health savings accounts as a positive move.
"The purpose is really to encourage lower-income families to have some ownership in their own health care," he said, figuring families that fall at or below 100 percent of the federal poverty level would pay in roughly $15 a month.
Rep. Doug Ervin, R-Kearney, co-author, said that as long as families pay into the account every month, the state will pay the remainder of any deductible that exceeds what's accumulated.
Neither Mr. Ervin nor Dr. Schaaf were sure how many people would be eligible for the program but said it would be similar to Mr. Blunt's plan, which would have covered roughly 54,000, according to
projections.
Don't expect yes votes from Democrats during floor debate. Opponents argue the program doesn't address the cuts to Medicaid made shortly after Mr. Blunt took office.
"If we're going to use our state resources ... we should make sure the people cut off in the blood-letting of 2005, that we look at a way to restore the most vulnerable people," said Rep. Mike Talboy, D-Kansas City, who voted against the bill in committee Thursday. "It doesn't cover enough of the working poor or disabled people."
Dr. Schaaf contended asking taxpayers to provide insurance to able-bodied people was "distasteful" but that other parts of the bill would help recoup the costs.
"It's going to cost taxpayers about $200 million more each year to do (Insure Missouri). It's only worth it if they get something comparable in return," he said.
He's tacked on language that would reform a state committee that considers new hospital applications, hoping to increase competition -- a segment that's drawn staunch criticism from the hospital community.
Also on the bill is a transparency component, which will require insurance companies to provide patients with coverage statements prior to procedures or surgeries. Having the information ahead of time would help patients make more informed provider decisions and eventually increase quality and reduce costs, he said.
Alyson E. Raletz can be reached at alysonraletz@npgco.com.
To see more of the St. Joseph News-Press or to subscribe to the newspaper, go to http://www.stjoenews-press.com/.
Copyright © 2008, St. Joseph News-Press, Mo.
Distributed by McClatchy-Tribune Information Services.
Subscribe To Lake AlertsMatt Blunt's first phase of Insure Missouri would have gone online in March, but he yielded to critics, including Rep. Dr. Rob Schaaf, R-St. Joseph, who have been busy crafting a substitute.
That legislation made it out of committee last week, setting it in motion for several more hurdles of debate before it lands in Mr. Blunt's lap.
Dr. Schaaf described Insure Missouri as a market-based program where people have individual health insurance policies purchased by the state.
Anyone between 19 and 64 who is employed, but doesn't have access to employer insurance and earns up to 85 percent of the federal poverty level is eligible for coverage in the plan's first phase. Future phases could bring eligibility up to 225
percent.
Those individuals will be responsible for monthly contributions to their own health savings accounts, which will be used to cover deductibles. Contributions will be based on income.
Despite concerns that families on the lower end will struggle to meet the monthly payments, the Missouri Catholic Conference supported the bill in committee.
"It's a long, complicated bill. It certainly could be improved, but the overall goal is a good one and that is to expand health coverage to the working poor," said Mike Hoey, assistant
director.
Mr. Hoey said the organization preferred Mr. Blunt's version of Insure Missouri because it required less cost-sharing from participants, but he dubbed the health savings accounts as a positive move.
"The purpose is really to encourage lower-income families to have some ownership in their own health care," he said, figuring families that fall at or below 100 percent of the federal poverty level would pay in roughly $15 a month.
Rep. Doug Ervin, R-Kearney, co-author, said that as long as families pay into the account every month, the state will pay the remainder of any deductible that exceeds what's accumulated.
Neither Mr. Ervin nor Dr. Schaaf were sure how many people would be eligible for the program but said it would be similar to Mr. Blunt's plan, which would have covered roughly 54,000, according to
projections.
Don't expect yes votes from Democrats during floor debate. Opponents argue the program doesn't address the cuts to Medicaid made shortly after Mr. Blunt took office.
"If we're going to use our state resources ... we should make sure the people cut off in the blood-letting of 2005, that we look at a way to restore the most vulnerable people," said Rep. Mike Talboy, D-Kansas City, who voted against the bill in committee Thursday. "It doesn't cover enough of the working poor or disabled people."
Dr. Schaaf contended asking taxpayers to provide insurance to able-bodied people was "distasteful" but that other parts of the bill would help recoup the costs.
"It's going to cost taxpayers about $200 million more each year to do (Insure Missouri). It's only worth it if they get something comparable in return," he said.
He's tacked on language that would reform a state committee that considers new hospital applications, hoping to increase competition -- a segment that's drawn staunch criticism from the hospital community.
Also on the bill is a transparency component, which will require insurance companies to provide patients with coverage statements prior to procedures or surgeries. Having the information ahead of time would help patients make more informed provider decisions and eventually increase quality and reduce costs, he said.
Alyson E. Raletz can be reached at alysonraletz@npgco.com.
To see more of the St. Joseph News-Press or to subscribe to the newspaper, go to http://www.stjoenews-press.com/.
Copyright © 2008, St. Joseph News-Press, Mo.
Distributed by McClatchy-Tribune Information Services.
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