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Filibuster blocks Medicaid bill on the final day of legislative session

May 14, 2004
By: Gaurav Ghose
State Capital Bureau
Links: HB 1566

JEFFERSON CITY - A mathematical misunderstanding became the center of one of the biggest political disputes in the Missouri legislature's 2004 session.

"During the month of March, we added more than 1,000 recipients daily," wrote Rep. Larry Morris, R-Springfield, in response to a newspaper's editorial criticizing a GOP plan to cut the Medicaid program that funds health coverage for lower income Missourians.

In the House debate during this year's legislative session, which ended Friday, on how the continuous growth in Medicaid enrollees is threatening to throw the Missouri budget out of control, House Republicans repeatedly cited that 30,000 March growth figure.

But it turns out the 30, figure was erroneous -- the result of comparing different enrollment figures for two months.

"The number surprised me," said Christine Rackers, Missouri's state Medicaid director.

Although the GOP enrollment figure may have exaggerated the issue, Missouri's Medicaid program has grown at a rate of 5.6 percent between march 2003 and March 2004. According to the March 2004 figures, the program covers more than a million elderly, blind, disabled and low-income families with children.

Chris Whitley, associate director of the Missouri Social Services Department, citing the final 2003 fiscal year figures, said more than half the enrollees are children but they are outnumbered by the elderly, disabled and the adults when it comes to total Medicaid dollar amount spent.

And the Medicaid program is estimated to cost $5 billion out of 2005 state budget of &18.9 billion.

On the reasons behind the expanding numbers, Janel Luck, deputy director of the department's Family Support Division, said that sometimes there are changes in eligibility requirements. She cited a state legislation which increased the income eligibility of elderly and people with disability.

Also, she said, the number increases due to enlarging the options. As examples, she cited the state taking up the federal option to cover women suffering from cervical and breast cancer and medical assistance for workers with disabilities. Besides, sometimes the economy, she said, is in such a condition when the workers are not able to get health insurance from the jobs they are able to get.

The House and Senate had split over the question of how deeply, if at all, to cut back in Medicaid spending. But neither side's prevailed as a result of a filibuster by Sen. Ken Jacob, D-Columbia, that blocked legislative action on the issue.

The House version of the bill would have eliminated coverage for about 65,000 people -- the majority of whom would have been the elderly and disabled, was described as too radical by some Republican senators.

Eventually, what emerged was a budget plan that would knock just 324 persons out of the Medicaid program.

Preventing more than 65,000 people from being kicked off was a success, said the House Democratic leader -- Rep. Rick Johnson, D-High Ridge.

"324 people at a tab of $158,000 were sacrificed to save their (Republicans') political face," Johnson said.