On Tuesday Gov. Jay Nixon visited Peoples Health Centers’ flagship site on Delmar (or Barack Obama) Boulevard in St. Louis to announce a proposal that would increase the Medicaid eligibility threshold in Missouri from 20 to 50 percent of the federal poverty level, providing health care “to nearly 35,000 additional parents,” he said.
The extra funding, he said, would come from the Missouri Hospital Association, with matching federal funds.
Nixon said he had spearheaded an agreement in which the association would contribute an additional $52.5 million a year from funds Missouri hospitals currently receive for providing uncompensated care to uninsured patients.
He said this investment by the MHA would allow the State to draw down about $93 million in additional health care matching funds from the federal government.
Together, he said, these funds would provide coverage for an additional 34,800 parents in Missouri.
“For us, this would affect some of our patients who are coming in currently as self-pay,” said Dwayne Butler, CEO of Peoples Health Centers.
“If some of our self-pay people would be covered, this would allow us to extend our services to others. It would enable us to fund more of what we do.”
There is a catch, however – Nixon would need support from the Republican-dominated Legislature.
The Missouri General Assembly would need to increase the eligibility threshold to 50 percent of the federal poverty level in the Fiscal Year 2010 budget. Currently, Missouri parents must make less than about 20 percent of the federal poverty level to be eligible for coverage under the state program.
“Today, too many parents are going without the medical care they need, or they’re turning to emergency rooms instead of a traditional doctor’s office,” Nixon said.
“As a result, families with health insurance are picking up this tab with higher premiums and co-pays.”
Marc Smith, president of the Missouri Hospital Association, urged legislators to support the measure.
“By using the funds our hospitals receive for uncompensated care to provide coverage for more parents, we’ll help more Missourians access primary care physicians, decrease wait times in our emergency rooms and move our economy in the right direction,” Smith said.
Nixon also has academic support, voicing the economic development agenda prized by most Missouri Republicans.
“Our economy is struggling, but this proposal will enhance economic growth, create or retain hundreds of jobs and drive down the cost of medical care for all Missourians,” said Timothy McBride, a health care economist, professor and associate dean for public health at Washington University.
“This will happen because this innovative partnership between Missouri’s hospitals and state government will reduce the number of uninsured Missourians, reducing the burden of uncompensated care for Missouri’s health providers and reducing cost-shifting to Missourians with insurance.”
Under this agreement, for example, health care eligibility for a single mother with two children would be about $9,155 a year, rather than about $3,700 a year
According to the 2008 “Cover Missouri” report by the Missouri Foundation for Health, more than 720,000 Missourians currently are living without health insurance, placing a considerable burden on Missouri’s hospitals and emergency rooms. The costs of caring for these uninsured Missourians are passed along to those with coverage in the form of higher premiums and co-pays.
Based on data studied prior to the 2005 health care cuts, Missouri families were paying between $110 and $291 more a year in premiums because of the cost of providing care for the uninsured. Estimates made before the 2005 cuts predicted that in 2010, Missourians would be paying an additional $225 to $609 a year to provide care to the uninsured.
Following the 2005 cuts, however, the number of uninsured Missourians rose significantly, so those initial estimates are likely lower than the actual premium increase Missouri families will see by 2010 without action to reduce the number of uninsured individuals in the state.
“Governor Nixon’s collaboration with the Missouri Hospital Association to provide care to approximately 35,000 Missourians is a first step in this healthcare crisis overhaul,” said Denise Hooks-Anderson, M.D., president of Mound City Medical Forum.
“After the 2005 Medicaid cuts, emergency rooms and community health centers saw an increase in their usage. Often times CHCs could not accommodate these extra patients. In addition, the premiums of the insured increased dramatically to compensate for the uninsured.”
But Anderson did not see the new proposal as anywhere near what is needed to address the problem of health care coverage in Missouri
“However, this proposed plan only impacts a small percentage of the total number of people uninsured in the state. Therefore, more must be done nationally to combat this problem,” she said, before issuing a kind of chant: “Universal Healthcare! Universal Healthcare! Universal Healthcare!”