Senate bill would hamper Missouri’s ability to fund Medicaid program

June 29--Some in Missouri's health care industry are sounding the alarm over the Senate health care bill's proposed changes to fund Medicaid and its potential to adversely affect the state budget.

Missouri and 32 other states use multiple taxes on health care providers as a way to help the state fund the government-run health insurance program for low-income residents. The Senate bill would lower the threshold on how much can be collected through provider taxes.

Some critics of the Senate bill say tinkering with that funding mechanism will put increasing pressure on state budgets, and states would be forced to absorb more responsibility in paying for the program.

"It has the potential to really harm the state's ability to fund Medicaid," said Dave Dillon, spokesman for the Missouri Hospital Association.

In Missouri, one in six residents rely on Medicaid for health care. The program covers almost half of all births and children in the state, and it pays for 63 percent of all nursing home care.

As it stands, health care providers play a large role in paying for the program that nearly 1 million Missourians rely on for care.

The state taxes on health care providers such as hospitals and nursing homes create a pool of money that the federal government matches. For every dollar the state spends, the feds contribute 63 cents, according to figures from the Missouri Foundation for Health.

Since the federal government is on the hook to match a certain percentage of what the state spends, the bill is attempting to lower that threshold over time. Right now, the more a state spends, the more it can receive from the federal government. Using those provider taxes is a way to increase the spending, and acquire more federal funds.

After it became clear that Republicans did not have enough votes to take up the Senate bill, the vote was delayed until after the July 4 break. Changes are being made to the bill to try to win support from different factions of the party. Some lawmakers and health care providers are concerned that revamping Medicaid will remain a priority.

At the same time the bill is attempting to reduce the amount states can rely on from providers, the bill also seeks to reduce federal payments overall, creating a much more dire situation, according to policy experts.

Without enough money to continue to cover those enrolled, the state would be forced to make decisions such as cutting Missourians from the program, reducing payments to providers or eliminating covered services.

"This really puts states in a place where they are going to be forced to make this really harsh decision and, once again, it's on the back of these low-income folks and health care providers," said Ryan Barker, vice president of health policy at the Missouri Foundation for Health.

Critics of the Senate bill say relying on provider taxes frees up state taxpayer money for other priorities, such as education or infrastructure projects.

___

(c)2017 the St. Louis Post-Dispatch

Visit the St. Louis Post-Dispatch at www.stltoday.com

Distributed by Tribune Content Agency, LLC.