Funding for the St. Louis Regional Health Commission’s Gateway to Better Health program was recently extended through the year 2022 after the State of Missouri received a five-year extension of its successful Gateway to Better Health Pilot Program from the Centers for Medicare and Medicaid Services (CMS).
The Missouri Department of Social Services, in partnership with the St. Louis Regional Health Commission, sponsors the Gateway program.
Through a network of community health providers, Gateway provides primary, specialty and urgent care coverage each year to approximately 24,000 uninsured adults, ages 19-64, who are poor and live in St. Louis and St. Louis County. For community health centers, this preserves up to $30 million in annual funding to help address the health needs for indigent care in St. Louis’ urban core.
Robert Freund, CEO of the St. Louis Regional Health Commission, said Gateway funds only a portion of uninsured adults, and community health center funding approved by Congress in the wee hours of February 9 is both separate and essential to keeping health centers in operation.
“Between the two pots of funding … that’s roughly half of all the funding they get,” Freund said. “For the adults, it’s either this pot of money or it’s Gateway, and that really helps provide access to the community health centers – and there are not a lot of other physicians outside of the community health centers that are seeing Medicaid or the uninsured.”
Federal funding for states to operate the Children’s Health Insurance Program, or CHIP, was renewed for two years following the first budget stalemate and government shutdown a few weeks ago. CHIP provides low-cost health insurance for children in families who do not qualify for Medicaid. In Missouri’s CHIP program, MO HealthNet for Kids covers uninsured children of families with low income who do not have access to affordable health insurance. The state also has a MO HealthNet for Pregnant Women and Newborns program.
“If we wouldn’t have gotten CHIPS renewed, Gateway renewed, and the community health center funding, we would have seen a significant reduction in access,” Freund said. “We would have seen significant job loss, and we would have seen site closures.”
Freund said the Gateway program received strong bipartisan support from elected leadership in Missouri and in Washington.
Under the terms of the extension, Gateway will continue coordinate, monitor and report on the Demonstration Project to cover individuals up to 100 percent of the federal poverty guidelines for primary, specialty and urgent care. The January 2018 poverty guidelines for the 48 contiguous states and the District of Columbia are $12,140 for a family of one; $16,460 for a family of two; -$20,780 for a family of three; $25,100 for a family of four; $29,420 for a family of five; and $33,740 for a family of six. (For more information, see https://aspe.hhs.gov/poverty-guidelines.)
Since July 2012, Gateway has annually paid for about 78,000 medical visits (primary care, urgent care, dental, specialty care, diagnostic services and outpatient hospital services), nearly 7,000 transportation rides to access medical services, and more than 268,000 prescriptions for the uninsured in St. Louis. Gateway also prevents an estimated 75,000 unnecessary emergency department visits each year.
For more information about Gateway eligibility, please visit http://www.stlgbh.com/.
