medicaid expansion

missouri capitol
Ryan Famuliner / KBIA

A Republican-led Senate committee considering changes to Missouri's Medicaid program has rejected a Democratic proposal in support of expanded eligibility.

The decision by the Senate Interim Committee on Medicaid Transformation and Reform dealt with what recommendations to include in a report in advance for the 2014 session.

Earlier Wednesday, Democrats walked out of the committee while it considered other recommendations for changing Medicaid.

A series of hearings by state lawmakers into Missouri's Medicaid system has begun.

U.S. Health and Human Services Secretary Kathleen Sebelius was in St. Louis on Thursday to talk about the Affordable Care Act.

Sebelius met with city and county officials and representatives of the local healthcare community in a closed-door session at St. Louis City Hall.

Speaking at a press conference after the meeting, Sebelius said as of October 1, Missourians will be able to purchase health insurance through a new online marketplace.

Sebelius said many of Missouri's 800,000 uninsured will be able to get coverage.

Teddy Nykiel / KBIA News

 

Echoing testimonies from earlier hearings in Independence and Springfield, witness after witness spoke in support of Medicaid expansion at a House interim committee hearing in Columbia on Saturday.

Teddy Nykiel / KBIA

A former health insurance company executive says he left the comforts of a padded career of corporate jets and high rise offices to speak out against unfair insurance practices.

This week on KBIA’s talk show Intersection, host Ryan Famuliner sat down with State Sen. Kurt Schaefer (R-Columbia), Rep. Caleb Rowden (R-Columbia) and Rep. Chris Kelly (D-Columbia) to discuss the legislative session that ended on Friday. One of the main things on the show’s agenda was, of course, Medicaid expansion – or lack thereof.

Famuliner asked the panelists why the expansion failed to pass. 

Kellie Kotraba / KBIA News

  

With the Missouri legislative session ending on Friday and a Republican supermajority that still won't budge, the hope to expand Medicaid in Missouri is pretty much dead for FY 2014.

It's so dead that perhaps the only thing that could bring it back to life is, well, interfaith prayers for a miracle.

The Missouri House has formally rejected the Senate version of the state budget, setting the stage for final negotiations over the state’s spending plan for next year.

An alternate Medicaid expansion bill that contained some reforms sought by Missouri House Republicans is all but dead this year.

A Missouri House committee heard testimony Monday on efforts to shift state welfare recipients onto federal disability.

A crowd estimated at more than 1,000 crammed into the Rotunda of the Missouri Capitol Tuesday to hear Governor Jay Nixon (D) call for expanding Medicaid to an additional 300,000 residents, nearly 260,000 of them by next year.


He told the crowd that the people he wants to add are those with low-paying jobs that don’t include health coverage.

Leader Nancy Pelosi / Flickr

Every Friday, KBIA's Health & Wealth Desk talks about the week's most interesting articles and reports on rural health, wealth and society issues. 

'Redneck reality' and rural portrayal in cable television

Entertainment newspaper The A.V. Club muses on A&E's popular reality show Duck Dynasty, saying the show is the 21st century incarnation of old rural-themed sitcoms that once dominated network television. Think Petticoat JunctionThe Beverly Hillbillies, and Hee-Haw. It's an interesting read, but we were especially interested with the author's take on ways the television shows have to negotiate the rural-urban political disparities. 

While the rural-themed programming of days gone by tended to depict the small Southern town as a bucolic haven for good-hearted folk, redneck reality is more apt to acknowledge the social and economic ills of the subcultures it depicts. These shows are sanitized for the protection of viewers with blue-state sensibilities; when they occur at all, political discussions tend to center on generalized platitudes about freedom and family, rather than specifics that might turn off half the potential audience.

 

H/T: The Rural Blog

Did headlines about death rates at rural hospitals tell the wrong story?
The Daily Yonder is killing it with their opinion pieces this week. 

Case in point: A new report made headlines last week, saying death rates are rising at rural, geographically isolated hospitals. But an opinion writer for the Yonder says news reports are not telling the real story of these so-called critical access hospitals:

The patients in the small rural hospital with heart attack, heart failure or pneumonia have become a select population. A large proportion has decided that they are through paying all the human costs of the miracles of modern medicine. They have made the decision to stay in familiar surroundings near home and family. 

The researchers found that 13.3% of the patients at critical access hospitals with one of the three conditions died, compared to 11.4 % of the medical center patients. Given all the terrible tools that modern medical centers have to work with, I’m amazed they only manage a small difference in patient survival over the most basic, little country hospitals in America. 

nomadsoul1 / dreamstime

In his proposed budget, President Barack Obama wants to delay cuts to federal payments to hospitals, keeping the payments intact for an extra year. That could affect the debate over expanding Medicaid in Missouri.

Through what’s called the disproportionate share hospital payments or DSH payments, the federal government gives money to hospitals that provide a lot of free care to patients who are uninsured and can’t afford services. The Affordable Care Act, though, includes significant cuts to DSH payments.

Images of Money / Flickr

The uphill congressional battle to expand Medicaid in Missouri is making rural hospitals that serve areas with high poverty levels really, really nervous. KSMU's Jennifer Davidson has the story.

Nixon open to GOP-backed Medicaid plan, but with changes

Apr 3, 2013
File photo / KBIA

Governor Jay Nixon says he could support the House Republicans’ alternate Medicaid proposal, but only if some crucial changes are made.  He met with the GOP caucus today to discuss his Medicaid expansion proposal and their plans to reform the system.  Nixon told reporters that any proposal still needs to expand Medicaid to 138 percent of the federal poverty level.

Tax Credits / Flickr

If Missouri expands Medicaid health coverage for lower-income adults, could it create a crisis for public schools?

If Missouri fails to expand Medicaid, could it result in millions of Missourians' tax dollars going to health care in other states?

Both claims have been made at the Missouri Capitol by opponents and supporters of a proposed Medicaid expansion. But the claims might be exaggerated.

Missouri Capitol
File Photo / KBIA

The Missouri House has passed a nearly $25 billion budget that would fund modest increases for public education, but not the Medicaid expansion sought by Gov. Jay Nixon.

Missouri Capitol
File Photo / KBIA

Missouri’s Republican-led House on Tuesday struck down Democrats’ attempts to include Medicaid expansion in the state’s budget.

If that scenario sounds familiar to you, it’s because these rejections have happened a few times before. On Feb. 25, two House committees rejected Rep. Jake Hummel’s (D-St. Louis) bill to expand Medicaid under the terms of the Affordable Care Act. On March 14, the Senate Appropriations committee voted down the Senate Democrats’ version of the expansion bill.

Rep. Jay Barnes (R-Jefferson City) was in one of the committees that struck down Rep. Hummel's Medicaid expansion proposal. Barnes has since introduced his own version of the expansion -- outlined in House Bill 700

missouri capitol
Jacob Fenston / KBIA

The Missouri House has rejected another Democratic effort to add a Medicaid expansion to the state budget.

The House opened debate Tuesday on the state's 2014 budget by defeating an effort to send the budget back to a committee in hopes of adding more than $900 million of federal funds to expand Medicaid for low-income adults.

The defeat of Tuesday's motion was almost a foregone conclusion in the Republican-led House, because the House Budget Committee had previously rejected the Medicaid expansion.

Regional news coverage from the KBIA newsroom, including:

  • Missouri House rejects Democratic effort to expand Medicaid
  • Mamtek CEO makes bail
  • Rep. Hartzler and Mayor McDavid call for funding to keep airport tower open
File / KBIA

Supporters and opponents spent several hours Monday testifying on an alternate Medicaid proposal being floated by House Republicans.

missouri house floor
File Photo / KBIA News

Some supporters of a Medicaid expansion championed by President Barack Obama are also embracing a Republican alternative put forth in the Missouri House.

Missouri's Republican-led committees have repeatedly defeated the Medicaid expansion backed by Obama and Democrats.

Rep. Jay Barnes (R-Jefferson City) is proposing the Republican alternative of the expansion. Among the witnesses testifying for Barnes’ plan in a House committee Monday were people who have stood by Democrats in recent weeks as they embraced a proposed Medicaid expansion for lower-income adults. 

Spring break has arrived for Missouri lawmakers, as they take a week off before returning to Jefferson City on March 25th.


They’ll have plenty of items on their plate when they get back -- among the House’s priorities is debating and voting on the state budget, which still does not include Medicaid expansion. Speaker Tim Jones (R, Eureka) says the federal health care law does not require states to add more people to the Medicaid rolls.

A Republican-led Missouri Senate committee has defeated a plan to expand Medicaid under President Barack Obama's health care law.

The Senate Appropriations Committee rejected the legislation on a party-line vote Wednesday, just minutes after hearing testimony from more than two dozen witnesses in favor of the plan.

A Republican-led House committee defeated a similar bill last month in the same fashion.

Harum Helmy / KBIA News

On this week's Health and Wealth Update, the first part of a discussion about health literacy and the healthcare reform. 

Harum Helmy / KBIA News

The St. Louis-based nonprofit, nonpartisan group Missouri Foundation for Health held a community forum in Columbia at the ARC Monday night about the state’s Medicaid expansion debate. The foundation’s director for health policy Ryan Barker presented the pros and cons of the expansion to an audience of about 45 people, before opening up the floor to questions.

Jay Nixon
File Photo / KBIA

Gov. Jay Nixon has raised concerns about a Republican-backed Medicaid plan.

Jeanine Anderson / Flickr

This week -- we’re hearing about the Medicaid expansion debate down in West Plains -- the seat of rural Howell County. A study by the Missouri Budget Project shows that Medicaid expansion would have its most dramatic impact in the state’s rural areas.

stopnlook / FLICKR

A long-promised Republican alternative to Medicaid expansion was filed today in the Missouri House.

Marshall Griffin / St Louis Public Radio

Medicaid expansion is dead for now in the Missouri House.  Two separate House committees voted down efforts Monday to expand Medicaid to 259,000 Missourians next year and 41,000 more in later years.

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