A Missouri House interim committee has resumed its series of hearings into the state's Medicaid system.
Lawmakers spent more than five hours Tuesday examining the current make-up of the system and some proposed changes, and that included taking a closer look at how some other states with GOP-led legislatures have expanded Medicaid. Committee member Chris Molendorp (R, Belton) was the only House Republican to support Medicaid expansion during this year's legislative session. He says Missouri should consider adopting Florida's practice of using Medicaid to cover so-called wrap-around services, such as providing transportation for kidney dialysis patients.
"A co-pay, a spend-down, a deductible, whatever you want to call it, is not relevant – they can't get to the dialysis clinic," Molendorp testified. "They either are so ill they cannot drive, or they don't own a car, or they don't have a friend or family member who's in a position to drive them to dialysis – missing a dialysis visit is serious business."
The committee also discussed Arkansas's recently-approved Medicaid expansion, in which federal money will be used to help the poor buy private health insurance coverage.
Another topic explored what role managed care might play in reforming Medicaid in Missouri. Committee member Rick Stream (R, Kirkwood) also chairs the House Budget Committee. He suggested that using managed care to run Missouri's Medicaid system could mean shrinking the state's workforce.
"It's a question that needs to be discussed," Stream said. "If we hire a company or a group of companies to manage (the) people receiving Medicaid services in our state, why would we need a lot of Medicaid state employees?"
The Missouri House Interim Committee on Medicaid Transformation is scheduled to resume hearings Wednesday.
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