Mo. Lawmakers Pass Legislation to Expand Heath Coverage

Some of the roughly 700,000 Missourians lacking health insurance could find it a little more affordable to get. But people who don’t pay their medical bills could lose their state income tax refunds under legislation sent May 11th to the governor.

The legislation is touted as a way to expand access to private health insurance and to let people carry their individual insurance policies with them when they take a new job.

The bill also addresses a growing liability for hospitals and other medical providers who treat patients who can’t or don’t pay.

The House gave final approval to the bill 106-41, a day after it cleared the Senate 31-0 with little discussion. Representatives then began debate on a massive bill that would revamp the government-run Medicaid health care program for the poor.

The private health insurance bill would expand the eligibility and lower the premiums for people to be covered by the Missouri Health Insurance Pool. The government-supervised program was created in 1991 to provide private insurance to people who cannot get or afford it, often because of chronic health problems.

About 3,000 Missourians currently are covered under the high-risk pool, according to Department of Insurance, Financial Institutions and Professional Registration.

Sen. John Loudon, R-Chesterfield, who handled the bill in that chamber, estimated an additional 10,000 to 20,000 people could be covered as a result of the expanded eligibility.

People covered under the high-risk pool presently pay premiums of 1.78 times the standard rate, but that could go up to twice the standard rate. Under the bill, people covered under the high-risk pool could not be charged more than 1.5 times the standard rate.

The insurance department estimates the bill would cost the state $7.5 million next year, growing to $25.2 million by the 2010 fiscal year.

The bill also would allow people to keep their individual insurance policies when they take a job with a small business that provides a group health plan. Instead of paying for that employee’s participation in the group plan, the business would pay an equivalent amount that could be used for the individual insurance premium.

Sponsoring Rep. Doug Ervin, R-Kearney, touts health-insurance portability as one of the most important parts of the plan.

Another supporter, Rep. Tim Flook, R-Liberty, predicted the bill would cause an “avalanche of change” that would “disrupt the (insurance) marketplace in a very good way.”

But some House Democrats expressed concern about a provision that would allow the state to deduct money from people’s income tax returns and lottery winnings to cover debt owed to hospitals and other medical providers. The state could keep a cut of up to 20 percent of the collected amount.

Reps. Margaret Donnelly, D-St. Louis, and Rachel Bringer, D-Palmyra, both lawyers, expressed concern that there were few legal protections for patients accused of not paying.

“We are setting up this state bureaucracy to go after these taxpayers who may or may not owe this debt,” Bringer said.

Republicans defeated a motion by Donnelly that could have sent the bill to a negotiating panel to come up with a different version.