Mo. Senate Democrats Storm Out of Medicaid Meeting

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JEFFERSON CITY- The Missouri Senate Committee on Medicaid Transformation and Reform met Wednesday to discuss the draft report they plan to present to the legislature before the session starts in January.

The report recommends expanding managed care statewide for low-income parents, pregnant women and children.

However, it was what the report didn't recommend that had Democrats talking.

Sen. Jamilah Nasheed, D-St. Louis City, started the Democratic backlash when she said Medicaid expansion was the most important issue surrounding Medicaid.

"What is the logic behind not expanding Medicaid when we have money on the table for the next three years, and we're looking for savings," Nasheed said. "The savings are there and we're not even talking about it."

Committee Chairman Gary Romine, R-Farmington, told Nasheed they would discuss expansion after going through the report, but Nasheed and other Democrats in the committee refused.

Along with Nasheed, Sen. Paul LeVota, D-Independence, and Sen. Joseph Keaveny, D-St. Louis City, left the meeting to draft their own recommendation for the report.

Romine argued the committee could not address issues with Medicaid expansion until they fixed the current Medicaid system to make it more sustainable.

"The foundation has to be laid," Romine said. "We have to have a strong Medicaid program this day before any other conversation can take place. That is my premise for this presentation of where we're at right now."

Missouri could be receiving more money from the federal government if it chooses to expand Medicaid, which Sen. LeVota said makes Romine's argument invalid.

"I don't think there's much validity because the program has changed," LeVota said. "The Congress passed a bill, the President signed it, the Supreme Court upheld it--the program is different and I think we need to deal with that reality as other states have."

All three Senators returned to the meeting over an hour later once the committee had finished discussing the draft report to talk about expansion.

Their report consisted four recommendations: that the state should expand Medicaid to 133 percent of the federal poverty level and accept the federal money, the General Assembly should consider waiver options for expansion, the estimates by the office of Budget and Planning display positive net savings to the state up through fiscal year 2021, and include the report by the "Kaiser Commission" that argues state spending growth should be lower for the 25 states moving forward with Medicaid expansion. 

The committee voted not to include the recommendation from the Democrats, which caused them to leave the meeting once again.

"Our message today was that if we're going to have a committee to talk about Medicaid transformation, the number one thing that was told to us over and over again in this committee was that Medicaid expansion needed to be a part of that conversation," LeVota said.

Romine argued the committee needed to include their recommendation so that public testimony does not go ignored.

"There was so much public testimony in favor of expansion that it wouldn't be appropriate to not address it," Romine said. "Although I don't think we can go after expansion until we've made it work better."

The committee did make minor changes to the report, including the decision to strike out efforts to enact a Prescription Drug Monitoring Program.

Several committee members also expressed concern over managed care, saying that the only people who want to expand managed care are managed care companies who can make money off of the program.

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