Rep. Keith Frederick will present language similar to HB 608 from 2013 this afternoon before the House Interim Committee on Medicaid Transformation.
The updated version of that legislation can be found here:
I’ve uploaded a PDF of proposed statutory changes to Medicaid which I will present at next weeks hearings of the House Interim Committee on Medicaid Transformation.
As with previous presentations, the inclusion of this proposal does not mean I or the committee will necessarily be endorsing it for passage by the General Assembly. What it does mean is that it contains key concepts which I believe should be discussed for Medicaid Transformation.
In addition to this proposal, the Committee will also receive presentations by Rep. Keith Frederick and Rep. Sue Allen, who will be presenting versions of bills they filed last year. I will post those bills tomorrow.
The Interim Committee on Medicaid Transformation is reversing the order of topics to be discussed next week. The following is the schedule we will follow:
October 29th, 1:00 p.m. – “Skin in the Game”
October 30th, 8:00 a.m. – Delivery Models and Managed Care Bidding
The House Interim Committee on Medicaid Transformation will take testimony tomorrow on services covered by Medicaid and Medicaid fraud. I’ve attached a PDF of a list of potential services covered in the form of a section of a potential state statute.
The following witnesses are also expected to testify:
· Joel Ferber, Legal Services– Medicaid Services overview
· Dr. Michael Bleich, BJC Goldfrab School of Nursing
· Brent McGinty, Coalition of Committee Mental Health Centers—substance abuse
· Jack Hollister, MO Psychological Association
· Dan Body, Regional VP for Behavioral Health for SSM Healthcare
· Brent Gilstrap, President of MO Mental Health Counselors Association
· Sherriff’s Association on topic of Mental Health coverage
· Jane Moore, MO Hospice and Palliative Care Association
· Lynne Barbour, DDS MO Dental Association
· Dr. Gary Henley Coalition for Dental Health
· John Kopp, Deputy Director of Medicaid Fraud Control Unit, Mo. AG
Here is the schedule for the House Interim Committee on Medicaid Transformation. The Committee will be taking expert testimony on these days – but only on the general topic areas listed for each day. Though the general areas of topics will stay the same, the bullet points underneath each topic are likely to grow as committee members submit ideas.
If you have subject-matter expertise and would like to testify on any of these topics, please contact Emily Walker in my office at 573.751.2412.
October 15th, 1:00 pm—Medicaid Fraud, Services Covered
October 29th, 1:00 p.m. – Delivery Models and Managed Care Bidding
October 30th, 8:00 a.m. – “Skin in the Game”
November 5th, 1:00 p.m. – ABD and Other Higher Cost Recipients
November 6th, 8:00 – Eligibility in Different Categoricals
November 19th, 1:00 – Conclusions
I’ve attached a PDF of mock legislation which would implement a Missouri version of the Iowa Option, the Medicaid reform recently enacted in Iowa. As with the mock bills modeled after Arkansas, the Patients Choice Act, and the Healthy Indiana Program this mock legislation is not my proposal for Medicaid transformation in Missouri – and does not have my endorsement. Instead, it is just another example of outside-the-box thinking which, if enacted, would bring market forces into Missouri’s Medicaid program.
I’ve attached a PDF of mock legislation which would implement a Missouri version of the Healthy Indiana Program, a Medicaid reform enacted in Indiana in 2007 under former Indiana Gov. Mitch Daniels.
Like Paul Ryan’s proposed Patients’ Choice Act, the Healthy Indiana Program provided for premium assistance for previously uninsured Indians who earned up to 200 percent of the federal poverty level. Like Ryan’s bill, Mitch Daniels’ Healthy Indiana Program is just one of many conservative proposals over the past 25 years to bring market forces to the Medicaid program – and to do so at the same time that they increase effective eligibility rates for the working poor. The Medicaid transformation proposal I sponsored last session attempted to use the same market forces to bring down the costs of health care for all Missourians.
The Obama administration recently extended Indiana’s waiver to continue running HIP. Eligibility, however, will be reduced to 100 percent of the federal poverty level, and Indianans on the program between 100 and 200 percent of the federal poverty level will be informed of the opportunity to enroll in a subsidized exchange plan. (Indiana has an exchange being run by the federal government just as Missouri does.)
As with the mock bills modeled after Arkansas and the Patients Choice Act, this mock legislation is not my proposal for Medicaid transformation in Missouri – and does not have my endorsement. Instead, it is just another example of outside-the-box thinking which, if enacted, would bring market forces into Missouri’s Medicaid program.
I’ve attached a PDF of mock legislation which would implement a Missouri version of Rep. Paul Ryan’s Patients Choice Act of 2009, which was presented as the Republican alternative to ObamaCare at the time it was being debated in Congress. The Senate champion of the measure was Oklahoma Sen. Tom Coburn.
The Patients Choice Act would have essentially increased Medicaid eligibility nationwide for families up to 200 percent of the federal poverty level. But it would have done so through tax credits and by providing these working poor families with debit cards through which they could use to buy their own private insurance. Ryan’s bill is just one of many conservative proposals over the past 25 years to bring market forces to the Medicaid program. The Medicaid proposal I sponsored last year included a similar approach – turning Medicaid recipients into participants by empowering them to choose their own health insurance plan in a truly competitive system which rewarded them for making affordable choices, and by providing each with a pre-paid debit card to use for co-pays in order to get them thinking about the costs of services just as every Missourian who pays the full freight for their health care does.
As with the mock bill modeled after Arkansas which I posted last week, this mock legislation is not my proposal for Medicaid transformation in Missouri – and does not have my endorsement. Instead, it is just another example of outside-the-box thinking which, if enacted, would bring market forces into Missouri’s Medicaid program.
Missouri is lucky to have some of the lowest electric rates in the country. But that might not always be the case. With a heavy reliance on coal and aging infrastructure, Missouri’s cheap electric rates are in serious jeopardy – and it just got a little bit worse today.
The New York TImes reports the Obama administration has fired the first serious shot in his War on Coal. The EPA has proposed a new rule limiting carbon dioxide emissions from new coal plants to just over half of the current average for plants with advanced technology. In practice, this likely means there will not be any more coal-fired power plants built in the United States. And since coal is the cheapest way to produce electricity, costs will go up.
The Times, however, also reports that this is just the first shot – and that the EPA will spend the next year developing a rule to place carbon emission limits on existing plants. Because Missouri electricity comes most from coal-fired power plants, this coming rule will hit Missouri families directly in the pocket-book as utilities will likely be forced to either shut down plants or spend huge amount of money retrofitting their coal-fired plants.
We’ve known this was on the way for quite a while. That’s why I’ve consistently supported legislation to make it easier for power producers to upgrade Missouri’s electric infrastructure and invest in new nuclear power plants. Unfortunately, those efforts have been stymied – mainly by big business interests controlled by Wall Street hedge fund managers and publicly traded companies more concerned about how “the Street” will react to their next quarterly earnings report than to long-term reliable and cheap power in our state.
Now that President Obama has fired the first serious shot in the War on Coal, it is my hope that we can pass legislation to help ensure affordable energy for Missouri families, businesses, and schools for decades to come.
Attached is draft legislation of “The Arkansas Model” incorporated into Missouri statutes. This Medicaid reform model will be discussed at the hearing of the House Interim Committee on Medicaid Transformation on September 26 at 1:00 p.m.
I will post more draft legislation as it becomes available for distribution.