By Rep. Maria Chappelle-Nadal
Missouri House of Representatives
District 72, University City, Missouri

Republican Governor Matt Blunt is hoping to set a national precedent by passing legislation to completely eliminate Medicaid in Missouri by 2008. Medicaid provides benefits to all low-income age groups with severe health or medical needs, not just the elderly. In Missouri, nearly one million people receive Medicaid benefits, including 550,000 Missouri children. Medicaid is the nations largest provider of nursing home care and it provides a buffer in times of recession, as employers cut benefits and increase layoffs. As a social safety-net service, Medicaid provides health and medical services to our most vulnerable citizens and insures that those unable to care for themselves are not only cared for, but are treated with dignity and respect.

Governor Blunt has cut state and federal funds for Medicaid by more that $626 million. This will not only eliminate Medicaid services for at least 130,000 MO residents and limit medically necessary services for hundreds of thousands of others, but will cause Missouri to lose about 10,000 jobs and $737 million in economic activity as well.

While many of the Medicaid cuts will be achieved by direct reductions in coverage and services to individual recipients, Blunt and the Republican state legislature also want to close public health care facilities, like Bellefontaine Habilitation Center, and let private, for-profit facilities take over.

Cutting people off Medicaid will not eliminate their need for medical care. Without health insurance and with little or no money to pay for care, the cost of these services will be shifted to doctors, hospitals, other safety net providers, families, correctional facilities, employers and emergency rooms. In short, to tax payers. Eventually, cost will be passed on to those with health insurance through higher premiums.

The Republican controlled House and Senate passed Senate Bill 539 for just that purpose. The bill establishes a Medicaid Reform Commission whose soul purpose is to end Medicaid as we know it by 2008. The Commission will make recommendations to the General Assembly by January 1, 2006 on “reforming, redesigning and restructuring a new innovative healthcare delivery system to replace the current state Medicaid system.”

I have been visited, called and emailed by hundreds of constituents and representatives from different organizations. I have felt encouraged by the outpouring of support and activity from our constituency. I have felt proud because our community came together to speak out for the entire community, not just one particular interest or another.

The cuts passed are outright evil. In our own district, 344 people will be cut off as of June and another 400 put into a transitional program off Medicaid. These cuts were made in the name of saving money according to the supporters of the bill, but the truth is that all this will do is increase spending in other programs, reduce our overall economic activity and put a drain on those of us who understand our call to help our neighbor in need.

You’ll hear a cry of difficult decisions and necessary cuts from the bill’s supporters. A cry of “What’s your solution?” The truth is that during committee, solutions were offered. Amendments to transfer funding from the stadium to adoptive parents were voted down. Amendments to pay to provide wheelchairs to disabled people by cutting the fee office spending were offered and defeated. The majority in the House of Representatives has claimed that their job has been the hard one, but here in the minority, nothing was more frustrating than knowing you have tried your hardest and still have not accomplished all of what you hoped to do to protect the people in you district.

It has been a hard, emotional week. I have had to listen to some of my fellow representatives claim that the cuts are necessary and that the only people being cut from the rolls are those that abuse the system. That government has gotten too big and that it’s not our job to make sure the most vulnerable are provided for.

As far as I’m concerned, that IS my job. We are a community, and as long as one member is in need, we all are in need.

If you would like to comment on this issue or any other, please feel to contact my office at (314) 725-7288.