Increasing Healthcare Access

By Brian L. Baker

Ronald Reagan once said, “Double, no triple, our troubles and we'd still be better off than any other people on earth. It is time that we recognized that ours was, in truth, a noble cause.”

Missouri sought a noble cause this past legislative session…creating access to healthcare system for our poorest citizens, reducing fraud in that system, and using tax-dollars wisely to help our neediest citizens first.

The Legislature approved Mo-HealthNet, a program that will provide a better health-care access for low income Missourians and replace the antiquated Medicaid program. The program increases choice, improves quality, and promotes preventative care. It transforms our healthcare safety net, empowers Missourians to be participants and focuses on health, wellness and prevention.

Senate Bill 577 – Mo-HealthNet establishes a new way to provide health care for low income Missourians that was developed with advice and suggestions from many Missourians across our state. For the first time in Missouri history, the program helps guarantee every participant has access to primary and preventative care.

While critics will shout that we have not done enough, as always, I will give you the strict facts about actions taken by the Missouri Legislature. Mo-HealthNet does the following:

• Recognizes that participants should have one central point of contact and a doctor who knows them personally.
• Gives participants the option to choose their health care home (A health care home improves the quality of care by allowing participants to decide together with their provider the most effective plan of care. To keep participants healthy, a health care home will provide regular check-ups, screenings and immunizations based on individual needs and emphasize prevention.
• Expands health care coverage to employed persons with disabilities and will cover foster children until they are 21 years of age
• Allows more children to be eligible for health coverage under the State Children’s Health Insurance Program (SCHIP).
• Expands coverage to an estimated 6,500 children in lower-income families who earn too much to qualify for traditional Medicaid but lack private health insurance.
• Restores coverage of dental and vision subject to legislative appropriation.
• Restores coverage of hospice care and medical equipment to thousands of adult Medicaid recipients.
• Provides women’s health and family planning services to women age 18 and older who lack employer-sponsored health care and earn up to 185 percent of the federal poverty level ($18,889 a year for a single woman).
• Increases access to children with parents participating in the state’s drug court program.
  Many features of Mo-HealthNet have already been adopted in the state’s healthcare system and in the FY08 budget.

Mo-HealthNet calls for a five-year plan to increase provider reimbursement rates. Proponents of the change say this will encourage more doctors, especially those needed in specialty areas, to accept Mo-HealthNet patients. The bill expands the number of healthcare professionals who receive liability coverage when they provide free medical services and creates a state fund with the mission of expanding healthcare services in shortage areas and enacts Medicaid fraud reform.

The Ticket to Work program, a key priority of the House since 2005, was included in the Mo-HealthNet legislation. Mo-HealthNet is going to allow people who are 100% disabled...to go back to work and earn a living and not lose they’re healthcare.

A disabled Missourian will be eligible to participate in Ticket to Work so long as his income is at or below 300% of the federal poverty level and his assets are less than $1,000 if single or $2,000 if married. Money saved in medical savings accounts or independent living accounts will not be included in total assets. Overall, the Ticket to Work will help approximately 3,200 disabled employees with healthcare coverage. A related component of Mo-Healthnet and SB 577 will help 1,800 employees at sheltered workshops qualify for healthcare coverage.

As a key to promoting wellness and prevention, SB 577 requires Mo-HealthNet participants to have a healthcare home and to enroll in health improvement plans. The plans will help them remain in the least restrictive level of care possible and will encourage them to use call centers and nursing help lines when an emergency room visit would be unneeded and costly.

Mo-HealthNet also provides for the implementation of a pay-for-performance reimbursement program to reward doctors for improving patients’ health. It also provides a tax deduction to encourage the purchase of long-term care insurance.

While some will argue and shout for more…we must recognize that our reforms now target our most needy citizens and our disabled while at the same time works to prevent fraud within our system. Our work was and is a “noble cause” and as President Reagan stated, “Double, no triple, our troubles and we'd still be better off than any other people on earth.”