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Advocates Demand Missouri Expands Medicaid Coverage by 2014

A campaign kicked off Wednesday to expand coverage to anyone making 138 percent of the Federal Poverty Level. Advocates say the move would cover an additional 250,000 Missourians.

Grassroots leaders and organizations in St. Louis converged Wednesday to announce a campaign to expand Medicaid coverage in Missouri, a move they say is critical for the state's working poor.

During a press conference at Kirkwood Baptist Church, faith leaders, advocates and Medicaid customers called for Missouri to adopt legislation that expands coverage to anyone making 138 percent of the Federal Poverty Level (FPL).

Under the current system, Missouri does not offer Medicaid to single adults, unless they are disabled, and parents or caretakers with dependent children must make 25 percent of the FPL to receive Medicaid. (See PDF for comparison of current eligibility requirements versus those under an expanded coverage system.)

"Missouri has one of the stingiest Medicaid programs in the country," Professor Sidney Watson from Saint Louis University School of Law told attendees. "It's harder to qualify here than in other states."

She said the adoption of expanded Medicaid coverage would reduce Missouri's uninsured population of 877,000 by a third. Caring for this population puts a strain on communities and hospitals, she added. 

Multiple presenters discussed the problem with a Medicaid "spend-down." Those who do not meet FPL requirements could qualify for Medicaid if they subtract medical expenses from their income to meet requirements, according to Missouri's Medicaid program MO HealthNet.

"To give me Medicaid with a spend down is like giving me a gift I can't open," Yvonne Samuel, a current Medicaid customer and representative of CHIPS said. "I want to be able to open that gift."

James Shortall, who suffers from bipolar disorder, said expanded Medicaid coverage would help him in his road to recovery. Shortall does not have insurance and does not qualify for Medicaid. As a result he relies on hospitals and emergency rooms for health care needs which he says has become a financial burden. Shortall spoke as a representative of NAMI.  

Watson noted contract and seasonal workers would benefit from the expanded coverage. Christopher Wood, of Paraquad said the move would help those with disabilities. 

"People are afraid of pursuing meaningful full-time jobs because they're afraid of loosing their insurance. This would mean bringing disabled people into more fully active roles in their communities," said Christopher Worth, of Paraquad.

Presenters called on Missouri's legislature to pass expanded coverage this year to go into effect in 2014. Federal funding would cover the expansion for the first three years with Missouri never having to pay more than 10 percent of the cost.

Expanding Medicaid coverage to anyone who makes 133 percent of the FPL was originally part of President Barack Obama's Patient Protection and Affordable Care Act, but the Supreme Court struck down the provision, leaving states to decide whether they will expand coverage, according to U.S. News and World Report

Presenters called on attendees to write to their state representatives in support of expanded Medicaid coverage.

"Missouri is at a crossroads of what kind of state it wants to be," said presenter Megan Burke, a senior policy analyst with Paraquad.

Mary Clemons January 17, 2013 at 01:11 PM
Great coverage of this event. Another factor in Medicaid expansion is that without it hospitals will be at risk. Missouri hospitals expect to soon lose $400 million a year in federal payments for caring for people who are uninsured. The federal payments will stop because most of the uninsured are expected to qualify for Medicaid coverage – if Missouri participates in the expansion. The Missouri Hospital Association is calling for expansion. Also studies have shown that 24,000 jobs will be created when Medicaid is expanded. The Missouri Chamber of Commerce is advocating for it.
foxxydrummer January 17, 2013 at 03:47 PM
And just who is going to pay for this? If these zealots are so intent on "helping" the poor, perhaps they should open their own wallets first.
kwrunnergirl January 17, 2013 at 05:57 PM
As a fellow "zealot" that wants the poor to be "taken" care of, I in fact do open my own wallet with my own tax dollars that I am more than happy to pay. I live in a society, a community with others and I put into my community what I use. More importantly the faith system I believe in leads me to be a compassionate human being and to not put money before people. As someone who also works for our local food pantry I also see the struggles of our working poor everyday and can't so easily lump everyone into one group- rather I understand that every person and family has their own struggles and can easily fall through the cracks in our imperfect system. I guess the Golden Rule doesn't apply to everyone- especially not those who would rather protect their money first.
Elizabeth O'Fallon January 18, 2013 at 04:31 PM
Do you know anyone who is actually on Medicaid? I know several folks that are and the care they receive is substandard. Will expanding this program improve the quality of care? I seriously doubt it. I think finding a private sector solution is a much better route to go.
Karen McKay January 24, 2013 at 12:51 AM
Most who are on the Medicaid program are grateful to have it in place. Many of our local State and Federal legislators are in an on going fight to keep the program funded. This is a public health program through which certain medical & hospital expenses of those having NO income, are LOW income, are paid for from state & federal funds. One of the largest groups that receive funds are the older population.
C Crowley February 12, 2013 at 12:46 AM
Interesting article my 15 yr old who is on a vent and has in excess of over $5000 dollars in medical bills most which are not covered by our primary insurance so he has had medicaid since 2009. Today I got a call saying they were converting him to a spend down. So on top of my primary insurance premium for a family of four I will now have to pay $173 a month to have his bills covered. Like most families with disabled children we don't live high on the hog. So to the person who thinks all those on medicaid are not deserving you are very ignorant.

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