Schaefer: Special session could change Medicaid

Among the 175 bills and resolutions still waiting for the Missouri Senate's approval today - the Legislature's last day for the 2015 session - is the federal reimbursement allowance, or FRA, that means more than $3.6 billion in Medicaid funding for the state budget.

"If we don't pass it, that money is not there," Senate Appropriations Chairman Kurt Schaefer, R-Columbia, told reporters Thursday.

Senate Republicans say they've been ready to pass the bill since last Friday, but Democrat filibustering has been holding the bill hostage.

"Every one in this chamber knows this bill is going to pass," Schaefer said, "and will pass in the first five minutes that it's allowed to reach the floor."

Democrats are upset with the Senate's GOP leadership for forcing a vote Tuesday on a controversial right-to-work bill the Democrats didn't support.

Sen. Scott Sifton, D-Affton, has said several times since the Tuesday vote there would be no more votes this session - and things like the FRA would have be called up in a special session.

The federal reimbursement allowance has been part of Missouri's Medicaid funding stream for about 25 year.

But, Schaefer reminded reporters he's been saying for some time that Missouri's Medicaid program growth is not sustainable in the future - and the additional funds going to Medicaid instead should "go into public safety, go into public education and a lot of other things," he said. "If we do get called into a special session, the bill will have to start over. It will go back to appropriations.

"And I look forward to a summer-long discussion and many appropriations hearings of digging down deep into the federal reimbursement allowance, how the Medicaid program works, and maybe making some serious changes that we really haven't had the political will to make in the Medicaid program, now, for a number of years."

Senate Minority Leader Joe Keaveny, D-St. Louis, doesn't see Schaefer's comments as a threat to force a vote on the FRA today.

"I'm not going to defend an inefficient Medicaid system," Keaveny said. "If we need to take a look at the Medicaid system, I think both sides ought to take a good look at it and see how we're going to proceed.

"I'm not aware of any inefficiencies. I serve on the Mo HealthNet oversight committee. But I'm willing to have that discussion."

Medicaid is a joint program, so state taxpayers contribute to it as well as the federal government.

Figures provided the News Tribune by the state Social Services department include expenditures by the Social Services, Health and Senior Services, Mental Health and Elementary and Secondary Education departments.

Since May 2004, they show the top total enrollment of people in the MO HealthNet program - Missouri's version of Medicaid - was 993,659 in February 2005.

And the lowest enrollment since May 2004 came in July 2007, with 803,564 enrollees.

In March 2015, the most recent numbers available, the program served 911,140 people.

Those people are served through several different programs:

• Children - 565,167 in March.

• Persons with Disabilities - 161,921.

• Custodial Parents - 80,335.

• Elderly - 77,264.

• Women's Health Services - 65,706.

• Pregnant Women - 26,453.

Links:

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