Medicaid expansion

Protesters disrupt the Missouri Senate on May 6, 2016.
Courtesy, Missouri Senate

It's a split decision in the trial of the so-called "Medicaid 23," a group of religious leaders who staged a protest in the Missouri Senate more than two years ago over lawmakers' refusal to expand Medicaid.

Twenty-two members of the group were found guilty of trespassing for not leaving the Senate gallery when ordered to do so by Capitol police. But they were found not guilty of obstructing the operations of the Senate. The case of one other member will be decided later.

Keith Carter, 53, waits to pick up a prescription for diabetes at Affinia Healthcare in St. Louis. Though he falls in the income gap, he's able to get his preventive care covered through Gateway to Better Health.
Durrie Bouscaren | St. Louis Public Radio

At any given time, a half dozen people sit in the waiting room at Affinia Healthcare in south St. Louis. Two parents coo over a new baby, while a group of older patients chat along the back wall.

53-year-old Keith Carter sits alone. An embroidered polo shirt and badge show he’s just come from work.

“I seem fit. Inside, it’s just breaking down like sawdust. I just keep it in motion,” he said, as he waited to pick up a prescription to manage his diabetes.

Gov. Jay Nixon made expanding Medicaid a top priority when he first ran for governor. While he made some small steps, he was largely unsuccessful in achieving that goal.
File photo by Carolina Hidalgo I St. Louis Public Radio

After Gov. Jay Nixon placed his signature on legislation that could expand Medicaid for Missourians who are disabled or elderly, I couldn’t help but think back to when the Democratic official visited Bob Pund’s apartment.

Nixon was a mere attorney general when he ventured into Pund’s residence back in 2007. Pund is paralyzed from the shoulders down and had been critical of major cuts made to Medicaid in 2005. As Nixon sat in Pund’s living room, the aspiring governor vowed to make reversing those reductions a priority of his eventual administration – even if he was faced with a Republican-controlled legislature.

Scottrade secured the naming-rights for the home of the National Hockey League's St. Louis Blues in 2006.
.bobby | Flickr

In our weekly "Behind the Headlines" segment, “St. Louis on the Air” host Don Marsh discussed several of the top news stories that caught St. Louisans’ attention this week, with the people that produced them and influenced them. 

Here’s what we talked about, including:

Chief Medical Officer, Dr. Johnetta Craig, walks to a meeting at the Carondalet location of Family Care Health Centers in St. Louis.
Durrie Bouscaren | St. Louis Public Radio

Despite the efforts of healthcare advocates, hospitals and notable former legislators, the Missouri legislature did not pass Medicaid expansion this year, or even bring it to the debate floor. That means an estimated 147,000 Missourians will have another year without health coverage, and the community health clinics that care for the uninsured will continue trying to bridge the gap.   

U.S. Sen. Claire McCaskill at a hearing at Washington University with more than a dozen experts in medicine and geriatrics 3/31/15
Jo Mannies | St. Louis Public Radio

As U.S. Sen. Claire McCaskill sees it, the Missouri General Assembly will be sharing more of the blame as the state’s medical professionals find it more difficult to provide the services and funding needed to care for Missouri’s growing elderly population.

Marshall Griffin/St. Louis Public Radio

Missouri lawmakers are heading home as their annual spring break has arrived, but they took time before leaving to tout their mid-term accomplishments.

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Bill Greenblatt | UPI

After two years of failing to convince Republican lawmakers to expand Medicaid in Missouri, Gov. Jay Nixon is pitching an alternative he hopes will sway enough of them to come aboard. But key Republicans remain cool to the idea.

Nixon, a Democrat, unveiled his new proposal Wednesday at appearances in Springfield and Kansas City.

Adrian Clark | Flickr

Administrators for Missouri’s Medicaid program told members of their oversight committee that they are getting closer to fixing their processing delays for new applicants. But the wait can still take months.  

“We are now under 13,000 pending applications. I think we will get into that normal, historical range within the next week,” said Family Support Division Director Alyson Campbell at an oversight committee meeting of MO HealthNet, the social services division that administers Medicaid in Missouri.   

Richard von Glahn explains the plan to canvass in House Speaker John Diehl's district as Judith Parker and Andrew Westbrook look on.
Camille Phillips | St.Louis Public Radio

Advocates continue to push for the expansion of Medicaid to include Missourians who fall in the so-called “coverage gap.”

Because Missouri has so far opted out of Medicaid expansion under the Affordable Care Act, thousands of Missourians fall into a gap -- they make too much money to qualify for Medicaid, but not enough to qualify for federal aid on the healthcare exchange.

State legislators have made it clear that expansion is unlikely to happen this year either.

But Medicaid advocate Richard von Glahn remains optimistic.

State Sen. Ryan Silvey, R-Kansas City, proposes to expand Medicaid to military vets currently ineligible for coverage.
Marshall Griffin | St. Louis Public Radio

A Republican member of the Missouri Senate is proposing expanding Medicaid to military veterans who are currently ineligible.

Adrian Clark | Flickr

The state agency that provides Medicaid coverage to more than 840,000 Missourians does not have proper oversight over contractors in charge of certain aspects of payment processing, according to an audit released Monday of MO HealthNet.  

The report by the office of Tom Schweich, the Missouri state auditor, identified four areas of concern:

Flickr/rosemary

To date, Missouri has failed to expand its Medicaid program as part of the Affordable Care Act, aka "Obamacare." As a result, federal dollars that would normally flow to underserved areas are being transferred to states that have expanded their programs. This loss of funding has major implications for health care in our state especially for those in areas of poverty and who are underserved. One particularly susceptible area is rural Missouri.

Sac-Osage Hospital in Osceola is a telling example.

Nixon RCGA 9214
Jo Mannies | St. Louis Public Radio

As the state – and his reputation – seeks to move beyond Ferguson, Missouri Gov. Jay Nixon is rekindling his longstanding pitch in favor of expanding Medicaid.

And Nixon may be seeking to subtly link the expansion with Ferguson’s headline-grabbing racial and economic unrest, by emphasizing what the state has been giving up in federal money – and what he said has resulted in less help to those who need it.

Jason Rosenbaum/St. Louis Public Radio

Former U.S. Sen. Kit Bond was tapped by the Missouri Chamber of Commerce to get Medicaid expansion across the finish line. 

He didn’t succeed. Despite the attempts of several Republicans in the House and Senate to pass some form of expansion this year, Bond told St. Louis Public Radio on Monday that “we were just a few filibustering senators short of getting it done.”

Marshall Griffin/St. Louis Public Radio

House and Senate members have sent the remainder of the bills that make up Missouri's state budget to Gov. Jay Nixon.

The roughly $26.4 billion spending plan increases higher education spending by 5 percent and adds $114.8 million for K-12 schools, which House Republicans called "historic."

With permission of Marie French | St. Louis Post-Dispatch | 2014

Twenty-three people were arrested at the Missouri Capitol Tuesday following a protest supporting Medicaid expansion. The protesters began shouting slogans and singing songs from the public gallery above the State Senate floor during debate on an unrelated bill.  

(via flickr/jimbowen0306)

The Missouri Senate passed the rest of the state budget Tuesday, after taking care of the first five bills on Monday. Those debates were routine for the most part, with the Senate approving the budgets for K-12 schools and Higher Education.

Nanette Hegamin

In the final weeks of the legislative session, Missouri Gov. Jay Nixon has made a last-ditch effort to resurrect a push to expand Missouri’s Medicaid program and accept roughly $2 billion a year in federal money.

The governor, a Democrat, unveiled his “Missouri Health Works’’ program before business leaders Monday in Cape Girardeau. By coincidence or design, state House Speaker Tim Jones, R-Eureka and an opponent of Medicaid expansion, was also in Cape on Monday with conservative low-tax icon Grover Norquist to highlight a different issue.

Commentary: Health And The Least Of Your Sisters And Brothers

Apr 27, 2014
seal of the state of Missouri
Missouri Secretary of State website

I realize that in many quarters there is a feeling that all federal spending, even for vital human services, must be cut. However, if we can put that aside for the moment and look at the reality of life in Missouri, I would offer these considerations.

“The poor you will always have with you and you can help them when you will.” Mark 14:7.

(Flick/Mark Coggins)

  Supporters of Medicaid expansion in Missouri continue to work on swaying opponents in the General Assembly over to their side. While it appears they have a long way to go, and the clock is ticking on the legislative session, some key advocates say they may be close to turning the tide, at least when it comes to a scaled-back expansion that would be paired with reforms. 

(Flick/Mark Coggins)

Missouri’s business community is getting more vocal in pushing the state’s legislators to expand Medicaid.

The St. Louis Regional Chamber held a panel Friday with business leaders who expressed frustration that the state is not capturing federal dollars to provide Medicaid coverage to more low-income residents.

This year, the state will pass up $2 billion dollars in federal funds.

After the panel discussion, St. Louis Regional Chamber President and CEO Joe Reagan said that Jefferson City needs to get the message.

In his hospital room at Touchette Regional Hospital in Centerville, patient Steven Glispie finishes signing the paperwork to enroll in Medicaid.
Véronique LaCapra | St. Louis Public Radio

For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.

Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.

But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.

Flickr Creative Commons Users/Compiled By Kelsey Proud, St. Louis Public Radio

The Obama administration says it will give people more time to sign up for health insurance through the federal online marketplace.

Marshall Griffin/St. Louis Public Radio

(Updated 4:30 p.m. Wed., March 26)

In the last six months alone, Missouri hospitals have eliminated nearly 1,000 jobs, imposed hiring freezes affecting another 2,145 positions and cut or delayed at least $50 million in building projects.

The blame is due, in part, to the General Assembly’s refusal to expand Medicaid.

Marshall Griffin/St. Louis Public Radio

The Missouri House has given first-round approval to next year's state budget -- after spending most of Tuesday on amendments to the FY 2015 budget, including two attempts to expand Medicaid.  Both failed, and both were sponsored by state Rep. Jill Schupp, D-Creve Coeur.

UPI/Bill Greenblatt

Missouri Gov. Jay Nixon is trying a new pitch in his quest to persuade state legislators to expand the state's Medicaid program and accept the $2 billion a year in extra federal money that would go along with it.

Nixon told supporters Thursday night in St. Louis County that the state’s current Medicaid program is so stingy that it discourages people from working — and could drive entry-level workers to other states that are expanding Medicaid.

Missouri now bars Medicaid coverage for anyone who earns more than $2,217 a year — which boils down to $42.63 a week.

Jason Rosenbaum/St. Louis Public Radio

State Sen. Rob Schaaf is a force to be reckoned with when it comes to health-care policy. But some believe that this staunch opponent of Medicaid expansion holds the key to ending the legislative impasse over it.

File Photo

HANNIBAL, Mo. – Missouri Attorney General Chris Koster –  now running for governor -- dove straight into the health-care debate Saturday when he attacked his former Republican colleagues for opposing Medicaid expansion and the Affordable Care Act.

“The Affordable Care Act was a Republican idea, for goodness sakes,” Koster declared. “They’re just pissed that we stole it.”

Marshall Griffin/St. Louis Public Radio

Former U.S. Sen.Kit Bond paid a visit to Jefferson City Tuesday, hoping to persuade his fellow Republicans in the Missouri House and Senate to expand Medicaid coverage to more people.

Bond told a gathering of Missouri Chamber of Commerce and Industry members that he doesn't like Obamacare, and he called its rollout a "disaster."  But he also said that accepting federal dollars to expand Medicaid could enable Missouri to craft its own health-care solution.

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