The Governor surprised all of us by asking the Speaker for permission to address the Majority Caucus. Naturally the Speaker set up a meeting and the Governor spent about an hour pitching the Medicaid Expansion to us. The Supreme Court decision last summer makes Medicaid expansion optional for the States. Although he prefers flat out expansion at any cost, he was willing to consider a proposed plan for reform from House Republicans. Obamacare will eventually force some kind of reform at the state level, but even as I write this report the Federal Government is extending deadlines. There is just way too much cost for us as a state to buy into the program as proposed. We have identified several key components we feel are critical to making the system a high-quality safety net:
-Encourage free-market principals and competition to lower costs. Give Medicaid recipients the power to choose the plan that best fits their solution.
-Incentivize preventive care.
-Promote price transparency to allow recipients to shop for the most cost-effective medical solutions
-Demand less Federal oversight and more flexibility. Empower our state to adapt to the program to meet the needs of Missouri's population and an ever-evolving health care industry.
-Reaffirm Medicaid's original purpose: to serve as a safety net for our most vulnerable citizens - seniors, children, and the disabled.
These are not a final solution to the Medicaid crisis by any means, but it is a starting point. There are innovative solutions being tried by other states. Arkansas for example is pushing for a system that would enroll those people newly eligible for Medicaid into the same private insurance plans available to individuals and small businesses. However we decide to proceed, we are dependent on the federal government to grant us a waiver that empowers our state to transform our Medicaid system.
We moved along several bills last week that had very little opposition. HB440 allows cottage food producers to continue selling products at farmer's markets, fairs, and to friends without the intervention of government by way of health department inspections. HB451 will allow counties to decrease their budgets during their fiscal year. In the event of dramatic declines in revenue or catastrophic expenses, counties will be able to respond responsibly. HB168 allows returning veterans to apply to 2 and 4-year colleges with a residency waiver. I hope this encourages all our returning vets to enter school in a Missouri institution.
This week we will start debate on some of the Senate bills that are coming over as well as some of our more complex legislation. I should have a bunch to report on next time, until then, I am and remain, in your service.