medicaid expansion

If you’re in the market for fluorescent light bulbs, you might talk to Chris Smiley. In the past few weeks, she’s been trying to sell off what’s left of Sac-Osage Hospital.

“Casework, lighting, plumping, sinks, toilets. Anything you want,” Smiley says.

That’s not in her job description. She’s actually the CEO of Sac-Osage, a hospital in Osceola, Mo., that closed in September.

Teddy Nykiel / KBIA News

Residents from across Missouri attended a press conference at the Missouri State Capitol on Wednesday to discuss the possibilities of Medicaid expansion in the state.

Five panelists led the conference and told their stories about being a part of the coverage gap. This term describes the situation of people who earn too much money to qualify for Medicaid but don’t earn enough money to pay for health insurance or qualify for incentives through the Affordable Care Act.

Jason Hoffman / KBIA

On the eve of the new legislative session, a group of community and faith leaders gathered in Jefferson City to demand action from lawmakers on Medicaid expansion. 

Images of Money via Flickr

The Affordable Care Act included a temporary bump in the Medicaid fees paid to physicians for certain primary care services. The intention behind the two-year, federally-funded increase was to encourage more physicians to participate in Medicaid to accommodate an expanding pool of Medicaid patients anticipated by the law.

But a 2012 Supreme Court decision opened a window for states to reject Medicaid expansion – Missouri is one of 23 states that have chosen not to expanded coverage – and as of Jan. 1, the Medicaid fee bump is expired as well.

I spoke with Dave Dillon and Andrew Wheeler of the Missouri Hospital Association (MHA) about the impact the fee increase expiration will have on Missouri hospitals.


Missouri lawmakers pre-filed more than 500 bills over the past month that they plan to take up during the next legislative session, which begins on Jan. 7. Here’s a selection of bills related to health care that St. Louis Public Radio’s Health Desk will be keeping an eye on in 2015:   

HB 282: Consumer Rate Review on Health Insurance Plans

healthcare.gov

  Last week marked the beginning of open enrollment for the federal health insurance marketplace, and on the surface it appears not much has changed. By some measures premiums before tax credits are just as affordable as last year - decreasing on average by about one percent according to a report by the Kaiser Family Foundation. But to be a savvy shopper, many consumers should give the marketplace a second look.

As the state – and his reputation – seeks to move beyond Ferguson, Missouri Gov. Jay Nixon is rekindling his longstanding pitch in favor of expanding Medicaid.

And Nixon may be seeking to subtly link the expansion with Ferguson’s headline-grabbing racial and economic unrest, by emphasizing what the state has been giving up in federal money – and what he said has resulted in less help to those who need it.

Ozarks Community Hospital says it will lay off up to 60 of its employees in the Springfield area.

How divisive was the debate over Medicaid expansion in Missouri this year?

Just ask Debbie Cole, a 51-year-old mother of four who lives in Butler, Mo., and signed a petition asking state legislators to extend Medicaid to cover more low-income residents.

“We all live different lives, and some people out there may be working two or three jobs and have no insurance, and they need it to survive,” she says.

David Sachs / SEIU

  

  By now Missourians are familiar with the debate over expanding Medicaid in the state.

The Affordable Care Act gives most people the opportunity to purchase health insurance with help from federal tax credits. But individuals earning too little to qualify for these tax credits but too much to be covered under for Missouri Medicaid are stuck in what is called “The Gap.”

A Missouri lawmaker is calling on Gov. Jay Nixon to preserve dental benefits for Medicaid recipients in next year's state budget when he signs the $26.4 billion spending plan into law later this month.

Maureen Lewis-Stump

Medicaid expansion has been a widely talked about subject throughout the state of Missouri. Medicaid is federally funded state healthcare program for those that do not make enough money to be their own healthcare, or their employer does not provide it for them.

The Medicaid policy in place now only covers those who make less than $4,500 a year total for a family of four. It also allows subsidies paid to those who make more than $89,000 a year. Those in between this gap are left without health insurance.

Former U.S. Sen. Kit Bond was tapped by the Missouri Chamber of Commerce to get Medicaid expansion across the finish line. 

He didn’t succeed. Despite the attempts of several Republicans in the House and Senate to pass some form of expansion this year, Bond told St. Louis Public Radio on Monday that “we were just a few filibustering senators short of getting it done.”

Missouri Capitol
j.stephenconn / Flickr

Missouri lawmakers are poised to give final approval to a state budget that could restore Medicaid benefits that were cut a decade ago.

Senate floor at the Missouri Capitol
File / KBIA

  Twenty-three Clergy members were arrested Tuesday during a rally at the capitol. The rally, by the group Missouri Faith Voices, was meant to get state senators to expand Medicaid eligibility.

Over 300 members of Missouri Faith Voices gathered in the rotunda for a rally before certain clergy members moved into the Senate Gallery. While, other members showed support outside of the gallery, the select clergy members sang and prayed out loud for about an hour before police arrested them.

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images_of_money / flickr

A renegade Republican has teamed up with minority party Democrats to deliver the first affirmative vote of the year for a plan to expand Medicaid eligibility.

missouri capitol
Jacob Fenston / KBIA

  The Missouri Senate passed the rest of the state budget Tuesday April 29, after taking care of the first 5 bills on Monday.  Democrat Paul LeVota of Independence made an indirect attempt to expand Medicaid. He offered an amendment to create a line item in the Department of Social Services’ budget for extra Medicaid dollars to be drawn down if lawmakers ever decide to expand Medicaid.  Republican Kurt Schaefer of Columbia opposed the amendment.

In the final weeks of the legislative session, Missouri Gov. Jay Nixon has made a last-ditch effort to resurrect a push to expand Missouri’s Medicaid program and accept roughly $2 billion a year in federal money.

The governor, a Democrat, unveiled his “Missouri Health Works’’ program before business leaders Monday in Cape Girardeau. By coincidence or design, state House Speaker Tim Jones, R-Eureka and an opponent of Medicaid expansion, was also in Cape on Monday with conservative low-tax icon Grover Norquist to highlight a different issue.

state capitol
Ryan Famuliner / KBIA

Missouri Gov. Jay Nixon has added a new prong to his proposal to draw down billions of dollars through a Medicaid expansion.

missouri capitol
Ryan Famuliner / KBIA

Some Missouri Republicans have adamantly opposed expanding Medicaid to low-income adults by tapping into billions of federal dollars under President Barack Obama's health care law.

Véronique LaCapra / St. Louis Public Radio

 

For years in most states, Medicaid eligibility had been limited to disabled adults, seniors needing long-term care and very low-income parents with their children.

Then along came the Affordable Care Act. It was designed to grow health insurance coverage across the board. One of its tenets was to expand Medicaid coverage beyond the extremely poor and disabled to include all adults earning up to 138 percent of federal poverty levels.

But in 2012, the Supreme Court gave states the chance to opt out Medicaid expansion.

Illinois is one of 25 states that went ahead with expanding the program. Neighboring Missouri did not.

We looked into the impacts of those differing decisions. Here’s what we found out.

(Updated 4:30 p.m. Wed., March 26)

In the last six months alone, Missouri hospitals have eliminated nearly 1,000 jobs, imposed hiring freezes affecting another 2,145 positions and cut or delayed at least $50 million in building projects.

The blame is due, in part, to the General Assembly’s refusal to expand Medicaid.

The Missouri House has given first-round approval to next year's state budget -- after spending most of Tuesday on amendments to the FY 2015 budget, including two attempts to expand Medicaid.  Both failed, and both were sponsored by state Rep. Jill Schupp, D-Creve Coeur.

Tax Credits / Flickr

Missouri lawmakers are hearing pleas from low-income workers, business leaders and pastors to expand Medicaid coverage.

Witness testifying Tuesday before a House committee want lawmakers to expand Medicaid eligibility to adults earning up to 138 percent of the federal poverty level — nearly $33,000 for a family of four. States that do so can receive billions of additional federal dollars under President Barack Obama's health care law.

missouri capitol
Jacob Fenston / KBIA

Several Republican state senators are making it clear that there will be no expansion of Medicaid eligibility this year in Missouri.

Five GOP senators took to the Senate floor Monday as the Legislature returned from spring break to say they will block any attempt to expand Medicaid eligibility during the session that ends in mid-May.

Kellie Moore, ColumbiaFAVS.com

Faith-based advocacy groups are uniting with hopes of making change in Missouri on behalf of the state's most vulnerable and marginalized population.

Representatives from groups around the state met Friday (March 7) in Quinn Chapel AME Church in Jefferson City to share the action they’re taking in their communities, and develop strategies on how to work together.

On their agenda: pushing for early voting. Improving public education. Expanding Medicaid.

Former U.S. Sen.Kit Bond paid a visit to Jefferson City Tuesday, hoping to persuade his fellow Republicans in the Missouri House and Senate to expand Medicaid coverage to more people.

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images_of_money / flickr

State officials are projecting that 24,000 new jobs would be created if Missouri chooses to expand its Medicaid program.

The Department of Economic Development said Friday that raising the program's eligibility to levels called for by the federal health care law would bring $9.9 billion in new wages to the state.

missouri capitol
Jacob Fenston / KBIA

The Missouri Senate has defeated an attempt to expand Medicaid eligibility to several hundred thousand lower-income adults.

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