Medicaid reforms implemented by GOP-led states can provide path forward in Missouri, Gov. Nixon says

Gov. Jay Nixon today visited the UMKC School of Nursing and Health Studies to discuss how reforms being pursued by Republican-led states like Indiana, Iowa and Utah should provide a path forward for strengthening and improving Medicaid in Missouri. The Governor said that strengthening Medicaid is a historic opportunity to implement reforms that protect taxpayers, reward work and promote personal responsibility.

"Across the country, Republican governors and legislators are bringing their tax dollars home and implementing innovative market-based reforms to Medicaid, while Missouri gets left behind," Gov. Nixon said. "These reforms would protect taxpayers, reward work, and demand personal responsibility -- but we can't implement them if we continue to stand still and send our tax dollars to other states. The time is now to strengthen and reform Medicaid the Missouri way."

Medicaid is the joint state/federal program that provides health coverage to low-income families and the disabled. Currently, states have the opportunity to strengthen Medicaid using tax dollars that they have already sent to Washington, D.C.

As of February, 28 states and the District of Columbia including Missouri's neighboring states of Iowa, Illinois, Kentucky and Arkansas have strengthened and reformed Medicaid. In states that are moving forward, the federal government is granting additional flexibility to implement reforms, such as premiums, co-pays and incentives to work or pursue job training.

Reforms the Governor discussed today include:

Protecting Taxpayers

Strengthening Medicaid will reduce the costs of Medicaid to the state budget. The net positive impact to the budget in Fiscal Year 2016 is projected at $117 million and $1.7 billion over the next 10 years.
Rewarding Work

Strengthening Medicaid would encourage low-income families to work, providing coverage to 300,000 Missourians making up to $27,000 a year for a family of three.
Through co-pays and cost-sharing, states like Arkansas, Pennsylvania, Iowa, and Michigan are requiring participants to contribute toward funding their health care, while allowing them to move up the economic ladder without losing their coverage.
Recipients who don't already have jobs would be automatically referred to career centers to help them look for work. Those who have jobs or who actively participate in job training/job search would have their monthly health care premiums reduced.
Under reforms implemented in Pennsylvania and proposed in Utah and Florida, those who refuse to work or actively seek work are required to pay higher premiums. Participants with incomes above 100 percent of the poverty level who do not pay those higher premiums would lose their health care coverage. Those below 100 percent of the poverty level would have to pay higher copays for services.

Helping Small Businesses

Currently, employers with more than 100 employees must provide affordable health insurance coverage to their employees or pay a penalty. In 2016, businesses with more than 50 employees will be affected.

Strengthening Medicaid is an opportunity to lessen this burden on small businesses by using the dollars freed up by reforming Medicaid to pay for about 60 percent of the cost of health premiums for eligible employees.

Employees would also be required to take personal responsibility by paying for a share of their health insurance costs.

Promoting Personal Responsibility

A number of states are implementing tiered coverage, with premiums or co-pays based on income level.
Arkansas, Pennsylvania, Iowa, and Michigan have implemented reforms that discourage recipients from cancelling appointments or improperly utilizing emergency services through increased copays or loss of incentives.
Recipients could also be charged for non-emergency use of ambulance services, and given incentives for making healthier lifestyle choices, such as quitting smoking, losing weight and eating right.

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