House plan would push up Medicaid eligbility

One of the most important aspects of the pending federal health care bill for Missouri could be how Congress expands Medicaid. Multiple versions of the federal legislation would push the minimum eligibility rates far beyond the Show Me State's current levels, a move that could force the state to expend resources when the provision goes into effect.

One Senate version of the health care bill would push the minimum eligibility rate to 133 percent of the federal poverty level. The feds would pick up most of the cost. But the House unveiled a new version of its health care bill today that would make the minimum rate 150 percent of the federal poverty level.

Details are still filtering in about how much the expansion would cost the state. Scott Rowson, a spokesman at the Missouri Department of Social Services, said the agency does not have a cost estimate on the House proposal yet. He said that the move would add roughly 291,000 people to the state's Medicaid program.

It should be noted that the final cost of the provision to the state probably won't be known until a final bill is passed and signed into law. Even if the House passed a bill that, say, made states pay for 40 percent of the expansion, that could be taken out when the House and Senate bills are combined later on in the process.

At least one member of Missouri's congressional delegation is speaking out against the expansion provision. Paul Sloca, a spokesman for U.S. Rep. Blaine Luetkemeyer, R-St. Elizabeth, sent the following e-mailed statement:

“At a time when states all across the country are being forced to make difficult decisions to balance their budgets, the powers that be in Washington have deemed it necessary to pass the mother of all unfunded mandates unto the states. This is wrong.  The federal government should not be forcing states to expand services they simply cannot afford.”

Sloca also wrote that according to a Democratic summary produced by the Ways and Means, Energy and Commerce and Education and Labor committees, the expansion would be paid for by the feds for the first couple of years. After that, states would have to pick up 9 percent of the expansion.

By the way, this is what Sen. Claire McCaskill, D-Missouri, said about the issue earlier in the year. She indicated that expanding Medicaid to 133 percent of the federal poverty level would make it harder for the bill to stay "deficit neutral:"