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Senate approves amendment to sunset Medicaid

March 15, 2005
By: Chris Blank
State Capital Bureau

JEFFERSON CITY - Thanks to a straight party vote, the Missouri senate voted to end the state's Medicaid program.

Senate Pro Tem Michael Gibbons, R-St. Louis County, proposed an amendment eliminating the welfare program by June 30, 2008. The amendment modified a larger Senate bill that would cut 89,000 recipients and reduce coverage for another 23,000.

"This system is not getting health care to the people who are eligible," Gibbons said. "It's allowing people who are not eligible to access the system and take money away from people who really need it. It's flawed, it's bad and it needs to go."

The state and federal program fund Medicaid, the state's largest welfare program. It pays health care expenses for almost 1 million low-income and elderly Missourians.

Gibbons said he believed the system would be changed well before the deadline outlined in the bill, but he "wanted to make an exclamation point to our commitment to change."

Sen. Pat Dougherty, D-St. Louis City, said setting an arbitrary date to eliminate such an important program was wrong.

"If this is a vision, then I don't want any part of it," he said.

Gibbons said he had no ideas about how to replace Medicaid but expected to work on ideas over the summer, hold hearings next session and create a new program next session.

The vote came in the heart of a two-day Democratic filibuster of a bill to reduce Medicaid eligibility. The bill goes hand-in-hand with the governor's proposed budget, making the cuts necessary to increase education spending.

Senate Democrats, however, said social services are not the place to make cuts. They said taxpayers will still have to pay for the care of would-be former recipients, whether it is through Medicaid or emergency room stays.

"These are hard decisions, but we don't need to be hard," said Sen. Yvonne Wilson, D-Kansas City.

Before voting to eliminate the entire program, the Senate voted to require more parents to pay premiums for a children receiving Medicaid.

Proponents said the change would save state dollars, but Democrats said the change would put 130,000 people at risk to lose their health care.

"This is a fine day for the Missouri Senate," Dougherty said. "This is just a great day. Why don't we all send a press release back home?"

At a news conference earlier in the day, Gov. Matt Blunt said Democratic detractors were defending an old, broken system and refused to accept needed reforms to verify eligibility requirements.

"People who are attached to the old way are opposed to social welfare reform," he said. "People who are attached to the old way think we shouldn't change our social welfare systems and that Missouri ought to spend a larger percentage of our budget on Medicaid than all but one other state."

Democrats spent much of the day unsuccessfully proposing floor amendments to restore parts of the programs falling under the Republican axe.

Sen. Victor Callahan, D-Jackson County, criticized the governor's plan and Republican senators for blindly accepting those plans.

"The stink of the executive branch is penetrating this legislature," Callahan said.

As tempers flared and a filibuster raged two floors above in the Senate chamber, 16-month-old Evelyn Canada crawled from row-to-row inside a House committee room in the capitol's basement.

Along with Canada was a gaggle of First Steps program enrollees and their parents who had gathered to prepare for a Senate committee hearing for a bill that would replace the program, which gives state aide to the guardians of disabled children from birth until age three, with a similar program.

Blunt and Gibbons, the sponsor of a Senate bill to create the new program, pushed for the new program after Blunt's proposed budget to eliminate funding for the program drew criticism from families and friends of the more than 8,000 participants and Democratic lawmakers.

Malinda Terreri, the mother of a former First Steps program participant, said she stood to gain nothing more from the program but was concerned future parents would not benefit as she did.

"We had a great program, and to go back to something that is middle-of-the-road or something that is not as great as it could be is a tough thing to do," Terreri said.

Blunt has said he supported replacing First Steps with a new program that would turn to private insurance before tax payer dollars.

In a news release, Blunt said he proposed the changes "out of genuine concern" and that they would "enhance the delivery of services."

But many of the parents of children involved in the program said the proposed new program was an attempt to grab political cover in response to widespread opposition.

The bill was heard in committee Tuesday afternoon, but no decision was reached.