MCC urges legislators to reform, expand Medicaid

April 14, 2014 JEFFERSON CITY, MO—With only one month remaining in the 2014 legislative session, the Missouri Catholic Conference (MCC) is urging state legislators to expand and reform Medicaid promptly.

In a floor letter distributed to the Missouri General Assembly on April 14, 2014, the MCC informs legislators that reform is needed so that individuals and families take ownership of their own healthcare while expansion is needed to ensure the poor, including the working poor, have access to affordable health coverage. Legislation that both reforms and expands Medicaid will recognize that healthcare involves both rights and duties.

The MCC also notes that Medicaid has been around for almost fifty years and is the primary publicly funded program that provides health coverage to the poor. The program offers health coverage for a broad array of life-saving medical services including: inpatient hospital services; outpatient hospital services; home health services; physician services; and lab and X-ray services. Prenatal care and other health services may encourage many women to choose life over an abortion, the MCC explains.

In the floor letter the MCC also points out that currently Medicaid in Missouri is limited to those with household incomes of no more than about 18% of the federal poverty level. For example, a mother with two children with an income just over $3,612 a year does not qualify for Medicaid health coverage. This mother also does not qualify for the premium subsidies available through the newly created insurance exchanges if her household income is below 100% of the federal poverty level

Mike Hoey, Executive Director of the MCC, wants to make sure that legislators remember the people behind the numbers.

“Expanding Medicaid will help store cashiers, hotel maids, home health care workers and others that don’t have a health plan now but need one,” he said.

Also in the floor letter, the MCC notes bills are pending that would require more personal responsibility, such as making co-payments for medical services and visiting family doctors instead of emergency rooms. Incentives are also offered for the adoption of healthier personal habits, such as limiting or giving up tobacco use.

•Please see the MCC Floor letter that is attached

To: Members of the Missouri General Assembly From: Missouri Catholic Conference Re: Support for Medicaid Reform and Expansion Date: April 14, 2014

With one month remaining in this year’s session of the Missouri General Assembly, the Missouri Catholic Conference (MCC) urges you to move promptly to both reform and expand Medicaid. Reform is needed so that individuals and families take ownership of their own healthcare. Expansion is needed to ensure the poor, including the working poor, have access to affordable health coverage.

Legislation that both reforms and expands Medicaid will recognize that healthcare involves both rights and duties. Each person as a creature of God has a right to basic healthcare; at the same time, individuals and families are called to care for their own health. Properly structured, Medicaid reform will place as much responsibility on individuals as is reasonable, but recognize when people need assistance from others.

Without listing particular bills, whose provisions may change as the legislative process unfolds, the MCC notes Medicaid reform bills are pending that would require recipients to take more ownership of their own healthcare:

•Require co-payments for medical services based on family income that discourage the use of emergency rooms for non-emergent health situations; •Promote the adoption of healthier personal habits including limiting tobacco use and changing other habits that adversely affect a person’s health; •Allow cash incentives to promote responsible behavior and efficient use of healthcare services; and, •Allow recipients to establish healthcare savings accounts to personally manage their healthcare purchases.

Expanding Medicaid is made contingent upon the federal government accepting such reforms. Furthermore, if the federal funds available for the expansion dip below the guaranteed 90% share, then the expansion is null and void. In this way, the Medicaid reform bills protect the fiscal integrity of the state of Missouri.

The MCC favors Medicaid reform with expansion. At present too few of the working poor have access to affordable health coverage. Currently in Missouri, Medicaid is limited to those with household incomes at no more than about 18% of the federal poverty level. For example, a mother with two children with an income just over $3,612 a year does not qualify for Medicaid health coverage. This mother also does not qualify for premium subsidies through the newly created insurance exchanges if her household income is below 100% of the federal poverty level. This Medicaid gap leaves many of the working poor with no access to affordable healthcare.

The working poor are more likely to be prevalent just below the federal poverty line at percentages such as 70%, 80% or 90% because of earning income from low-wage or part-time employment. These individuals are cashiers at grocery stores, provide home healthcare for the elderly, or clean up hotel rooms, etc. Some work two part-time jobs so their employers do not offer a health plan. If Missouri chooses to expand Medicaid from 18% of the federal poverty level to these higher percentages, the program will reward those who are trying to support themselves and their families. It is a way to uphold the dignity of work and workers.

Medicaid has been around for almost fifty years and is the primary publicly funded program that provides health coverage to the poor. The program offers health coverage for a broad array of life-saving medical services, including inpatient hospital services, outpatient hospital services, home health services, physician services, and lab and x-ray services. Prenatal care and other health services may encourage many women to choose life over an abortion.

Some suggest that rather than reforming Medicaid it should be replaced with some other approach. At this time, however, it appears very unlikely that Medicaid will be repealed. Medicaid reform offers the most practical way to ensure the wise use of tax dollars, encourage recipients to take responsibility for their healthcare and offer health coverage for the working poor. The MCC, therefore, urges members of the general assembly to move forward with Medicaid legislation that will both reform and expand the program.

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