Capitol Report
Senator Delbert Scott

For Immediate Release

For Immediate Release


A Prescription for Medicaid

            The situation facing Missouri’s Medicaid program is compelling for change. Over 140 new recipients of Medicaid are added to the roll each day in Missouri. As of this January, 985,546 people were enrolled. This is nearly one in five Missourians. More people are enrolled in Medicaid than are enrolled in Missouri’s public schools.

            This skyrocketing load on the Missouri budget is not sustainable. In 1968 when Medicaid began, it accounted for less than four percent of the budget. Now Medicaid spending has exceeded 23 percent of the state budget. Even Governor Holden agrees with the severity of the problem by stating, and I quote “Missouri’s budget is being crushed by the growth in the program.”

            For too long, Missouri has measured compassion by the number of people bound to our state’s Medicaid rolls. Instead, it should be measured by the quality and access we offer to the truly needy. Among this list are our indigent population who need these services, but Medicaid rolls have far exceeded this list. We must realize that anyone we help off of welfare by extending a hand up and not a handout is true compassion and a measure of success.

            Common sense solutions do exist and need to be addressed by the Legislature. This list should include a consistent asset limit across the board for the Children’s Health Insurance Program (CHIP). Current law allows the parents of an eligible child to have ¼ million dollars in the bank and still qualify and earns up to 300 percent of the federal poverty level for a family of five (this is $60,000) and still be eligible. This needs to change. In addition, a loophole exists that allows people with hundreds of thousands of dollars in assets to shelter these resources in annuities and get on Medicaid. This too must change.

            A proven means test must be adopted by case workers to review financial data of applicants. The CHIP is supposed to be available to those who do not have access to existing insurance. If case workers don’t ask, then applicants qualify by default. It has become a common practice for many who have access to insurance and the resources to pay to simply sign up on the state program for “free health coverage.” A significant portion of the growth in Missouri Medicaid is in this category. Furthermore, Missouri has a presumptive eligibility policy. This policy states that if an applicant waits more than 45 days for approval, they automatically are enrolled. Only seven other states in the entire nation provide such a loophole. This protection is meant to keep applicants from needless waiting but has been used to qualify people by simply not looking at their application. A proper review needs to be available.

            Sorting through true needs and protecting Missouri’s assets from blatant abuse can be a tough balance. However, the Legislature and Governor need to pass true reforms to keep Medicaid and welfare expansion from bankrupting our state. Proceeding on our current course will guarantee collapse of the system and even the truly needy recipients of Medicaid will not have a proper safety net of service.

Please feel free to contact me on this issue or any other issue at 573-351-2663 or by e-mail at