NPR Story
9:22 am
Thu August 15, 2013

Mo. Senate Panel Hears From Backers And Opponents Of Medicaid Expansion

Originally published on Fri August 16, 2013 1:27 pm

A Missouri Senate interim committee looking into the state's Medicaid system heard from several doctors and other health care providers Wednesday at a hearing in Jefferson City.  

Among those testifying was Thomas Hale, M.D., a St. Louis-based physician working with Sisters of Mercy.  He told the panel that Medicaid needs to be expanded to make up for the pending loss of federal reimbursements to hospitals, known as DSH payments ("dish").

"If we can't increase the Medicaid rolls and those that have insurance, then the DSH payments will be a significant negative impact on all the hospitals in the state, and certainly with the Sisters of Mercy," Hale said.  "We are at tremendous risk financially…on the other hand, it is our responsibility to change our cost structure so we can adapt to the payments as they are, and if we keep people out of hospitals, if we don't feed the beast (and instead) grow the village, then that won't be as big an issue."

Others testified that Medicaid needs to be reformed first before any expansion is considered.  Jeffrey Kerr, M.D., is a family practice and emergency services physician in Houston, Missouri.  He told the panel that Missouri's Medicaid system is being defrauded by people using their services to engage in doctor shopping to gain access to controlled substances.

"A lady who was (recently) in our ER had 15 providers that she (has seen) in this past year to get multiple narcotic prescriptions, and they're filled at taxpayer's expense," Kerr said.  "When I talk to MO HealthNet about that, they say 'darn the legislature, because they don't give us the money to monitor the system.'"

The Republican-led General Assembly refused to grant Democratic Governor Jay Nixon's call to expand Medicaid during the 2013 regular session.

Follow Marshall Griffin on Twitter:  @MarshallGReport

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