Draft Report: Missourians Favor Medicaid Expansion

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JEFFERSON CITY, MO.聽 —聽聽They traveled to six, far-flung Missouri cities. They held marathon public hearings. They got detailed state briefings.

So what did the 52-member conclude?

That people want both Medicaid expansion and reform.

A seven-page draft report circulated by state Rep. Noel Torpey, R-Independence, the group’s chairman, ends with that statement. There is no elaboration. The rest of the report generally highlights testimony received, without naming witnesses.

For example: 鈥淲itnesses discussed the need for greater care coordination for Medicaid recipients and the benefits of giving recipients a stake in their health care.鈥

Though the report is light on details, Torpey said the undertaking could have a big impact on the Legislature鈥檚 Medicaid deliberations next year.

鈥淚 can look someone in the eye and say, 鈥楻epresentative, this is what we heard time and time again, and we need to keep an open mind鈥欌夆 about expansion, he said.

鈥淚 think if we do the right kinds of reform, there鈥檚 a chance of getting expansion done,鈥 he said.

Last spring, the Republican-controlled Legislature rejected expanding Medicaid as envisioned by the Affordable Care Act. The federal government would have paid the full cost for new participants the first three years, with the state picking up a share after that.

Critics said that the safety net program for the poor was flawed and adding people to the rolls was financially unsustainable.

The topic is likely to be on the Legislature鈥檚 agenda again in January. The key question is, what reforms will legislators seek?

Asked for an example of a needed change, Torpey said Medicaid currently paid for knee replacements but not the follow-up rehab therapy. 鈥淭hat鈥檚 just crazy,鈥 he said.

He also called for more transparency in hospital billing practices.

Some of the House working group members were disappointed that the group wasn鈥檛 given a chance to hash out specific recommendations. The panel included 14 legislators and 38 non-legislators, many of them with expertise in various health care sectors.

鈥淵ou had this high-powered group of people that spent 90 hours of their own time and money, and (the chairman) never had them engage in a dialogue among themselves,鈥 said Dr. Ed Weisbart, a member from Olivette.

He said some might have declined the appointment if they had known they were 鈥渏ust being a transcriptionist.鈥

Torpey said House Speaker Tim Jones, who appointed the committee, had been clear from the start that the group鈥檚 goal was simply to receive public testimony.

He said working group members could submit written comments, which will be appended to the report.

Then, the document will be handed off to , which will meet Wednesday morning to decide how to develop legislation.

A also will meet Wednesday morning. Experts from the Center for Health Law Studies at St. Louis University鈥檚 School of Law are expected to testify, among others.

The meetings will precede the Legislature鈥檚 annual veto session, which kicks off at noon.

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