Barnes: Bill would streamline Medicaid eligibility

Rep. Jay Barnes filed a Medicaid transformation bill Tuesday that would streamline eligibility standards for Medicaid and result in fewer Missourians being eligible for the program.

Barnes, R-Jefferson City, said the bill would save Missouri taxpayers at least $742 million and potentially more than a billion dollars over eight years, transforming "Missouri's public health care welfare system into the most market-based Medicaid system in the entire country."

"We do that by empowering participants to make cost decisions for the first time in the history of the federal program," Barnes said. "When recipients sign up, they receive a menu of plans available with the prices attached to those plans, and they're told to make the affordable decision."

He said if recipients choose a plan that saves Missouri taxpayers money, the recipients get to keep a portion of the savings.

Those no longer eligible for Medicaid because of the proposal's streamlined eligibility standards could fall within another provision of the bill.

"The reductions that are included in the bill would be contingent on the existence of a federal health care exchange where substitutes are being offered and those families who will no longer be eligible for Medicaid would be eligible to receive a subsidy," Barnes said.

In some cases, he said, the subsidy would only require families to pay 3 percent of their annual income for a family health insurance plan.

Barnes' bill also reduces Medicaid eligibility for children.

"The added cost of a child in an exchange health insurance plan would be zero," he said. "It makes more sense, both in terms of family finances and in terms of hassle for families to sign up for coverage under an exchange and have separate coverage for their children."

Barnes' bill is an alternative to a bill rejected by a Missouri House committee Monday. The rejected bill, sponsored by Rep. Jake Hummel, D-St. Louis, fell in line with President Obama's call to expand Medicaid. The bill would have expanded Medicaid to as many as 300,000 Missourians, expanded Medicaid eligibility requirements to 138 percent of the federal poverty level and created 24,000 news jobs in the state.

Barnes is chairman of the House's Government Oversight and Accountability Committee, which rejected the bill 5-2.

Since Monday, Barnes said he's received nearly 100 e-mails, thanking him for voting down Hummel's bill.

"The one proposed by the Minority Caucus is simple, straight expansion of a system that's broken and that gets poor results for both recipients and taxpayers," Barnes said.

When introducing his bill last week, Hummel said the House Minority Caucus is willing to work with House Republicans on Medicaid legislation.

Barnes is also up for negotiation, knowing his bill will be amended throughout the legislative process.

He said he hasn't received a lot of feedback on the Medicaid transformation bill he filed Tuesday, but what feedback he has received has been positive.

"It's a difficult issue to understand," Barnes said. "It takes a while for people to understand these things.

"That's why I think there hasn't been much reaction yet."