Local legislators on opposite sides of the issue argue the cases for and against Medicaid expansion
Rudi Keller Posted: Sunday, February 23, 2014 2:00 am, Columbia Tribune
JEFFERSON CITY — The single costliest program operated by state government is Medicaid, which provides health care to children, poor parents, the disabled and the elderly at a price of more than $9 billion annually.
In December, supporting care for 891,264 recipients cost $648 million. That obligation is shared between the state and federal governments, with state taxpayers paying 38 percent of the total. Expanding coverage would change that equation as up to 350,000 uninsured adults enroll at no direct cost to state taxpayers until 2017.
If Missouri had already accepted that deal, program coverage would have expanded Jan. 1. Supporters estimate that Missouri would be receiving $5 million daily to pay for that coverage, equaling a loss to the state of more than $250 million since the beginning of the year. Rep. Jeremy LaFaver, D-Kansas City, created a poster to show the daily increasing total outside his Capitol office.
“I think it helps inform people in a way they understand,” LaFaver said.
Medicaid was originally created in 1965 along with Medicare. Eligibility for Medicaid is, for most recipients, tied to their income, expressed as a percentage of the federal poverty guideline, $11,670 for a single person and $23,850 for a family of four as of Jan. 1.
The lowest eligibility level is for adults who are not elderly or disabled. If they have children, they can obtain coverage if their income is below $292 a month for a family of three. The highest eligibility cap is for children in families earning up to 300 percent of the poverty level. Parents in that category can pay a premium if they are unable to obtain affordable coverage elsewhere.
Adults without children are not eligible at all.
The Affordable Care Act would expand coverage for people earning up to 138 percent of poverty, or $16,104 for a single person or $32,913 for a family of four.
Legislators have filed several bills to restructure Medicaid in Missouri, and some include all or part of the expanded population. Most Republicans publicly oppose expansion. But they say privately that expansion might pass, but no vote will take place until after the legislative spring break, which ends March 24.
Filing closes March 25 for legislative seats.
Rep. Chris Kelly, D-Columbia, and Sen. Kurt Schaefer, R-Columbia, have been outspoken in their support of, in Kelly’s case, or opposition to, in Schaefer’s case, Medicaid expansion. The Tribune asked them to sum up their points.