They traveled to six, far-flung Missouri cities. They held marathon public hearings. They got detailed state briefings.
So what did the 52-member House Citizens and Legislators Working Group on Medicaid Eligibility and Reform 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: “Witnesses discussed the need for greater care coordination for Medicaid recipients and the benefits of giving recipients a stake in their health care.”
Though the report is light on details, Torpey said the undertaking could have a big impact on the Legislature’s Medicaid deliberations next year.
“I can look someone in the eye and say, ‘Representative, this is what we heard time and time again, and we need to keep an open mind’” about expansion, he said.
“I think if we do the right kinds of reform, there’s a chance of getting expansion done,” he said.
Resistance
Last spring, the Republican-controlled Legislature rejected expanding Medicaid as originally outlined by the Affordable Care Act, often referred to as Obamacare.
The federal government would have paid the full cost for new Medicaid participants the first three years, with the state up to 10 percent of costs after that.
Critics said that the safety net program for the poor was flawed and adding people to the rolls was financially unsustainable.
That includes critics in Kansas, which is governed by conservative Republican opponents of Obamacare. Kansas is among the states that have shown no interest in broadening the program, despite entreaties from Kansas hospital officials and other groups.
The topic is likely to be on the Missouri Legislature’s 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. “That’s just crazy,” he said.
He also called for more transparency in hospital billing practices.
No specific recommendations
Some of the House working group members were disappointed that the group wasn’t 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.
“You 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,” said Dr. Ed Weisbart, a member from Olivette.
He said some might have declined the appointment if they had known they were “just being a transcriptionist.”
Torpey said House Speaker Tim Jones, who appointed the committee, had been clear from the start that the group’s goal was simply to receive public testimony.
He said working group members could submit written comments, which will be appended to the forthcoming report.
Then, the document will be handed off to another House committee, which is meeting Wednesday morning to decide how to develop legislation.
A Senate committee studying Medicaid reforms is also meeting Wednesday morning. Experts from the Center for Health Law Studies at St. Louis University’s School of Law are expected to testify, among others.
KHI News Service coverage of Medicaid expansion
→ Medicaid Access Coalition launches online “ticker” showing foregone federal dollars (2/13/14)
→ KHI report: Nearly 182,000 Kansans in the ‘Eligibility Gap’ (1/11/14)
→ House speaker says Medicaid expansion is “up to the governor” (1/10/14)
→ KS Senate president says Medicaid expansion unlikely to gain approval this session (1/7/14)
→ Profiles of the coverage gap: Kathleen Christian (1/6/14)
→ Efforts continue to expand Medicaid in Kansas and Missouri (1/6/14)
→ Hospital association hires former Bush HHS secretary to help craft a plan Kansas Republicans might support (12/23/13)
→ Iowa wins approval to expand Medicaid by using federal funds to buy private insurance (12/11/13)
→ White House officials hold call to urge Medicaid expansion in Kansas (11/21/13)
→ Republican governor talks up plan to expand Medicaid — his way (10/28/13)
→ Challenger says Brownback owes voters a decision on Medicaid expansion (10/22/13)
→ Nearly 5.2M Americans fall in coverage gap in states not expanding Medicaid (10/16/13)
→ Sebelius: Feds flexible on how states expand Medicaid (9/22/13)
→ Sebelius says Kansas and Missouri are missing the boat on Medicaid expansion (9/20/13)
→ Medicaid expansion coalition finds strength in numbers (9/17/13)
→ Republican Gov. Corbett proposes expanding Pennsylvania Medicaid (9/16/13)
→ Kansas lawmakers urged to consider Medicaid expansion by Wesley CEO (8/29/13)
→ Report: States not expanding Medicaid stand to benefit most from doing so (7/18/13)
→ CMS won’t penalize hospitals in states slow to expand Medicaid (5/14/13)
→ Insurer Centene: We can do Arkansas-style Medicaid (5/14/13)
→ The Arkansas Medicaid Model: What you need to know about the ‘private option’ (5/2/13)
→ Nothing to be done about coverage gap in states not expanding Medicaid, feds say (4/29/13)
→ Brownback says he’s listening to Medicaid expansion proponents, opponents (4/5/13)
→ Oregon shows costs of putting Medicaid enrollees in private coverage (3/29/13)
→ Governor urged to expand Medicaid eligibility (3/27/13)
→ Arkansas Medicaid expansion attracts other states’ interest (3/26/13)
→ Senate president prefers options remain open on Medicaid expansion (3/25/13)
→ States urged to expand Medicaid with private insurance (3/22/13)
→ Senate budget amendment underscores opposition to Medicaid expansion (3/21/13)
→ Study: Kansas employers face millions a year in possible penalties without Medicaid expansion (3/15/13)
→ More than 30 Kansas groups pushing for Medicaid expansion (3/12/13)
→ Health insurers see big opportunities in health law’s Medicaid expansion (3/8/13)
→ Medicaid expansion supporters to step up lobbying efforts (3/7/13)
→ Budget committee hears resolution opposing Medicaid expansion (2/22/13)
→ Legislators focusing on Medicaid expansion cost estimates (2/19/13)
→ Kansas hospital group study predicts expanding Medicaid would generate 4,000 jobs (2/18/13)
→ Brownback officials release their cost projections for Medicaid expansion (2/8/13)
→ Medicaid expansion bill introduced (1/22/13)
→ Kansas hospitals worried about loss of dollars for charity care (1/14/13)
→ Brownback compiling own estimate of Medicaid expansion cost (12/20/12)
→ Group urges Brownback to expand Medicaid eligibility (11/9/12)
→ Debate begins on possible Kansas Medicaid expansion (10/25/12)
→ Amerigroup CEO says states ‘need’ to go along with Medicaid expansion (7/11/12)
→ Kansas hospitals ready to get on with federal health reform, spokesman says (7/2/12)
→ Kansas AG claims partial victory in health reform case (6/29/12)
→ High court upholds Affordable Care Act, but ruling puts limits on Medicaid expansion (6/28/12)
Commentary
→ Kansas Hospital Association: An opportunity for the Kansas Medicaid program
→ Americans for Prosperity-Kansas: Well-intentioned policies do more harm than good
→ Health Reform Resource Project: The cost of not expanding Medicaid
→ Rep. Jim Ward: Medicaid expansion essential for healthier Kansas
→ Rep. David Crum: Reasons for opposing Medicaid expansion
→ National Academy for State Health Policy: Much ado about Arkansas: Medicaid in the insurance exchange
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