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Federal health officials renew waiver preserving special Medicaid benefits for area residents

This article first appeared in the St. Louis Beacon, Sept. 30, 2013: Much to the relief of health officials in the region, the federal government has decided to renew a waiver that guarantees continued health-care services to thousands of patients who signed up for Medicaid under a pilot program. Called Gateway to Better Health. The program has been offering primary, specialty and urgent care to more than 23,500 residents in St. Louis and St. Louis County.

The program was supposed to be a one-time experiment for certain indigent people who normally wouldn’t qualify for Medicaid. It was set to end on Jan. 1, when enrollees were expected to be folded into an expanded Medicaid program in Missouri.

But when state lawmakers refused to expand Medicaid, future health services to Gateway enrollees were put at risk. That changed Friday with the disclosure that the Centers for Medicare and Medicaid Services would grant the area a one-year waiver for continuation of Gateway program. During that period, officials hope Missouri will expand its Medicaid program, seen as the long-term answer to boosting quality care to the area’s needy.

Robert Fruend, CEO of the St. Louis Regional Health Commission, said the extension preserved $30 million in annual funding for area health care through December 2014. He added that the region succeeded in getting the waiver as a result of the help from the state's U.S. senators, Claire McCaskill, a Democrat, and Roy Blunt, a Republican; U.S. Reps. William Lacy Clay, D-St. Louis, and Ann Wagner, R-Ballwin; Gov. Jay Nixon; County Executive Charlie Dooley, and St. Louis Mayor Francis Slay. All had appealed to federal officials to extend the waiver.

Washington made one change in the funding. The grant will be limited to covering recipients earning up to 100 percent of poverty or $12,490 for a single individual. Current eligibility allows individuals with incomes as high as 133 percent of poverty or about $15,282 for an individual. Fruend says the change means other ways will have to be found to accommodate those who have lost coverage under the new guidelines.

The commission says benefits of the Gateway program have included primary care and dental services for 47,000 patients, more than 150,000 medications to control chronic illnesses and diseases, and more than 28,000 visits for specialty and diagnostic care.

In addition, the care prevented at least 50,000 emergency room visits last year.

Fruend says the Gateway funding represented about 20 percent of the total budgets of participating community health centers in the St. Louis area.

Robert Joiner has carved a niche in providing informed reporting about a range of medical issues. He won a Dennis A. Hunt Journalism Award for the Beacon’s "Worlds Apart" series on health-care disparities. His journalism experience includes working at the St. Louis American and the St. Louis Post-Dispatch, where he was a beat reporter, wire editor, editorial writer, columnist, and member of the Washington bureau.

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