No doubt you have heard in the news that
Governor Nixon met with Republicans this week to promote his ideas for Medicaid
and to intimate that he supports our efforts of true, positive, Medicaid
transformation in Missouri. The
Supreme Court decision from last summer makes Medicaid expansion optional for
the states. While he may promote flat out expansion at any cost, he was willing
to consider support for a proposed plan for reform from House Republicans. We
also agree that it should be Missourians, not the federal government, who make
these pivotal decisions for our state.
The
conservatively led Missouri House is committed to finding the best solution for
Missouri. We will not jeopardize the best health outcomes for our neediest
citizens nor will we risk the financial stability of our state by expanding a broken,
unsustainable system to include 300,000 more people. We must fix Medicaid so
that it provides access to quality health care for our most vulnerable citizens
at a reasonable cost to taxpayers.Medicaid has proven itself inefficient, and many recipients receive lower quality care than individuals with private insurance or even those with no insurance at all. Many doctors refuse to take new Medicaid patients because of low reimbursement rates. And because the current system lacks competition, there is no incentive to improve care or control costs.
The failures of the current system make it imperative that we enact actual, meaningful reforms rather than slap a billion-dollar Band-Aid on a broken system. If we are going to do what is best for Missourians, we must transform our Medicaid system so that it provides high quality care to those who need it most. This means taking a commonsense, conservative approach and transforming our system into a good investment that results in healthy, productive citizens.
As we undertake the challenge of transforming Missouri’s Medicaid system, there are several key components that are critical to making the system the high-quality safety net it was meant to be:
Encourage free-market principles and
competition to lower costs. Give Medicaid recipients the power to choose the
plan that best fits their situation.
Incentivize preventative care.
Promote price transparency to allow
recipients to shop for the most cost-effective medical solutions.
Demand less federal oversight and more
flexibility. Empower our state to adapt the program to meet the needs of Missouri’s
growing population and an ever-evolving health care industry.
Reaffirm Medicaid’s original purpose:
to serve as a safety net for our most vulnerable citizens – seniors, children,
and the disabled.
Medicaid
was never meant to provide healthcare to everyone. Rather than expand the pool
of recipients who receive increasingly diminished services, we need to
transform Medicaid into a system that ably provides the highest quality care to
those who need it most.
House
Republicans are currently exploring a market-based, transformative approach to
Medicaid. It incorporates many of the components listed above. The bill, HB
700, sponsored by Rep. Jay Barnes would move private insurers into a position
of greater competition to provide coverage for low-income Missourians. It would
empower Missourians, turning recipients into participants who actively make
health care decisions and not wait until their health care needs require the
emergency room. This system has the potential to vastly improve quality of care
while containing costs and reaffirming Medicaid’s role as a true safety net.
HB
700 is not the final solution to the Medicaid crisis, but it is a solid
starting point. From here we can work toward a sustainable Medicaid system that
can continue to meet our state’s needs for years to come. We will continue to
monitor the innovative solutions proposed by other states. Arkansas, for
example, is pushing for a system that would enroll those newly eligible for
Medicaid into the same private insurance plans available to individuals and
small businesses.
Regardless
of how we proceed, in the end we are dependent on whether the federal
government will grant us a waiver that empowers our state to transform our
Medicaid system. The White House structured Medicaid expansion as a
take-it-or-leave-it ultimatum when it comes to states getting federal dollars
for the program. However, as the President sees more and more states refuse to
accept the money along with all rigid federal requirements, we see a greater
willingness to allow state governments flexibility to transform Medicaid as
they see fit.
