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Silvey: Expand Medicaid at least for veterans

Coverage would aid families not eligible for VA care January 21, 2015 at 5:10 a.m. | Updated January 21, 2015 at 5:10 a.m.

State Sen. Ryan Silvey knows some of his colleagues don't like the idea of expanding Medicaid.

However, he's hoping the opposition won't include Missouri military veterans.

"As you know, the Affordable Care Act has created a coverage gap that, for those between 19 percent of poverty and 138 percent of poverty, have no access to health care coverage," the Kansas City Republican told reporters Tuesday.

"Those above that get subsidies from the federal government. Those below that are on Medicaid."

As he looked at possible health care changes the state can do, Silvey said, it became more evident that a number of Missouri veterans need assistance, and there are "around 22,000 spouses, particularly, their families who fall into this gap and need coverage."

He plans to introduce his "Veterans' Family Health Care Act" when the Senate meets this morning, "which will be, specifically, targeted to only veterans," Silvey said Tuesday, noting veterans also will be included in other Medicaid-related bills he plans to file in the next few weeks.

But Silvey expects those broader Medicaid-expansion bills are more likely to draw colleagues' filibuster efforts.

"It's also important to note that the (veterans only) bill, as introduced, will not require a waiver," he explained. "We certainly can provide coverage up to 138 percent (of poverty) without the waiver."

That means the state would have a larger share of the Medicaid costs, Silvey acknowledged, and seeking a waiver of the normal Medicaid rules would allow the federal government to pay 90 percent of the costs rather than 60 percent.

"I think we need to solve the problem, whether we do it expensively or cheaply," he said.

Sen. Ed Emery, R-Lamar, is one of those likely opponents - and he told the Associated Press Tuesday: "I think the opposition is more fundamental than who it goes to.

"My concerns would be the same."

Dewey Riehn, the Veterans of Foreign Wars' legislative chairman, said expansion would benefit many veterans and their families.

He noted individual veterans can get medical help from the federal Veterans Administration, but "there is nothing for the family ... there's no plan available for their family."

Riehn said the VFW has no position on the general Medicaid expansion program envisioned by the Affordable Care Act and championed by many Democrats.

"Every time we're looking at legislation, and I'm working in the Legislature, I look for components that affect veterans," he explained. "We would not testify in favor of (general) expansion.

"We probably would not testify against it."

Both Riehn and Silvey said there's no discrimination, if lawmakers approve a veterans and families Medicaid expansion but not a bill for the rest of the state's population.

"If you look at the history, at both the federal and state level, of veterans and programs, veterans are an identifiable class that is already set apart in other areas," Riehn said, such as VA Home Loans and the GI Bill's financial assistance for a college education.

The bill Silvey expects to file today includes the families of deceased veterans, he said.


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