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Missouri Hospital Association

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

Proponents of a Medicaid expansion in Missouri want to allow voters to override the state's Republican leaders, who have refused to extend coverage to more people.

The Healthcare for Missouri coalition is collecting signatures on a petition that would place a Medicaid expansion on the November 2020 ballot. If approved by voters, Missouri would expand the health insurance program to those who earn up to $18,000 a year. Missouri is one of 14 states that has not made the program available to more low-income people.

Campaign organizers say the expansion is necessary to extend health care coverage to people who have jobs but lack health insurance.

New nurse Becky Boesch looks through files as part of her job as a nurse in the cardiac step-down unit at St. Luke's Hospital in Chesterfield.
Sarah Fentem | St. Louis Public Radio

The Missouri State Board of Nursing has approved expanding five of the state’s nursing programs, adding 250 slots for future students.

State officials say the move aims to help reduce nursing vacancies. The profession has one of the highest vacancy rates in the health sector, with 13 percent of positions unfilled in Missouri, according to the Missouri Hospital Association.

Medical assistant Raquis Tyler, Dr. Heidi Miller and nurse Cindi Boehm discuss treatment plans for patients at Family Care Health Centers in St. Louis.
File photo | Tim Lloyd | St. Louis Public Radio

Two years ago, registered nurse Amanda Sommer decided she had had enough. She was working as a bedside nurse in a large St. Louis hospital, floating among different departments and taking care of half a dozen patients for 12-hour shifts. Because of staff shortages, her manager often scheduled her to work both nights and days, and the lack of routine was wearing on her.

Sommer left that hospital in 2016 and worked as a home health nurse before leaving the workforce to start a family. She’s one of many health workers who have left their job in recent years. According to a report from the Missouri Hospital Association, health workers are increasingly leaving their jobs. Nearly 18 percent of workers in Missouri and metro east hospitals surveyed by the association left their jobs in 2017, up from 16 percent the year before.

Given the intricacies of individual insurance plans, co-pays and hospitals' calculations to determine how much to charge for care, it is no simple feat to figure out how much your health care costs. Shopping around for around for the best price in town? Even harder. But a new set of data released Wednesday by the Missouri Hospital Association might make that process a little bit easier.  

This article first appeared in the St. Louis Beacon, Sept. 19, 2013 - An uninsured parent of two children would have to bring home less than $9.59 a day to qualify for Medicaid in Missouri, the federal-state insurance program for the needy.

"This precludes almost all working adults from Medicaid eligibility in Missouri,” says a study, titled A View of Two Missouris, released Tuesday by the Missouri Hospital Association.

This article first appeared in the St. Louis Beacon: Missouri hospitals are expected to avoid about $27 million in cuts in federal reimbursements.

The Obama administration's next budget eliminates about $500 million nationally in what’s known as disproportionate share payments, or DSH, to hospitals under Medicaid. These payments are made to certain urban and rural hospitals that treat large percentages of poor patients lacking health insurance. Ozark Medical Center in West Plains, Mo., was among rural hospitals concerned about the cuts. It was set to lose more than $600,000 in DSH payments, starting in the next federal fiscal year, beginning on Oct. 1.

This article first appeared in the St. Louis Beacon, Jan. 16, 2013 - As nurse practitioner Judith Gallagher related story after story of families or individuals who had no health insurance or had lost it – and couldn’t qualify for Medicaid in Missouri – she emphasized one common fact about each case.

“These are not people trying to get free rides from hardworking taxpayers,” Gallagher said, her voice rising. “These ARE hardworking taxpayers.”

This article first appeared in the St. Louis Beacon, Jan. 8, 2013 - The so-called fiscal cliff debate involved a lot more than whose taxes would rise this year. On Jan. 1, when Congress reached a compromise to stave off widespread tax hikes, the legislative package included a measure that spared doctors from sharp reductions in Medicare reimbursements. That deal is expected to cost hospitals millions of dollars in federal payments for treating the needy.

This article first appeared in the St. Louis Beacon, Dec. 5, 2012 - For the Missouri Hospital Association, the key to getting legislators on board with a push to expand Medicaid is making a pitch about the move’s economic opportunity — and the practical consequences of inaction.

"It isn't the matter that 'we should expand Medicaid because it's the right thing to do, although that is certainly still a strong argument,'" said MHA spokesman Dave Dillion. "Not only could we accomplish that, but we could create an economic engine by doing that."

This article first appeared in the St. Louis Beacon, July 3, 2012 - Gov. Jay Nixon, a Democrat, already is under pressure from Republican legislators who vow to oppose any expansion of Missouri’s Medicaid program, as called for under the federal Affordable Care Act, which was largely green-lighted last week by the U.S. Supreme Court.

But now, he’s a target on his left flank as well.

This article first appeared in the St. Louis Beacon, Aug. 30, 2011 - When the Commonwealth Fund searched for hospitals that were doing good work in reducing avoidable and costly readmissions, it turned to St. John's Regional Health Center in Springfield for a case study. The choice was a good one. An analysis of three years of data from the Centers for Medicare and Medicaid Services (CMS) shows that St. John's is the best among Missouri hospitals in lowering readmission rates for heart attack, heart failure and pneumonia patients.

This article first appeared in the St. Louis Beacon, July 20, 2011 - When an athlete limps into an orthopedic surgeon's office for treatment of a swollen ankle these days, he or she is likely to be asked to sit before a computer and use questions and illustrations on a high-definition screen to explain the cause and location of the pain.

This article first appeared in the St. Louis Beacon, July 28, 2010 -  The federal health-reform train began rolling across America this summer, dropping off benefits at every stop along the way, offering coverage to children with pre-existing conditions, giving added protection to young people about to be removed from their parents' health plans, and setting up temporary high-risk pools for some unable to buy affordable insurance.

This article first appeared in the St. Louis Beacon, March 31, 2009 - Notwithstanding stiff GOP opposition in Jefferson City, Gov. Jay Nixon continues to pursue his campaign promise to expand health coverage for Missouri's uninsured.

On Tuesday, his proposal picked up support from one of the state's most influential business groups, Associated Industries of Missouri. It endorsed the plan at a press conference with Nixon at Boeing Co., in north St. Louis County.

This article first appeared in the St. Louis Beacon, March 9, 2009 - With his key health-care initiative stalled in the Missouri Legislature, Gov. Jay Nixon is turning to other approaches to expanding health insurance to the needy and unemployed.

On Monday, he appeared in several cities across the state to announce what he says is a landmark agreement that will bring health care to nearly 35,000 parents at no increased cost to the public.