Shaping Policies. Creating Opportunities.

Senate Committee Hears Bill to Dramatically Alter Medicaid

The Senate Committee on Seniors, Families and Children heard testimony on a bill that would allow dramatic changes to the way Missouri operates its Medicaid program.

Sometimes referred to as the Global Waiver bill or the Block Grant bill, Senate Bill 28 (Sater) would:

  • Authorize the Department of Social Services to apply for a waiver that would suspend rules and regulations that govern Missouri’s Medicaid program.  In its place, the state would provide rules for governing the Medicaid program.
  • Ask the federal government to cap payments to the state to cover all the costs of care for the entire Medicaid population based on a preset formula, and not actual state health care costs. The preset formula “may include provisions, to the fullest extent possible, that propose or accept a federally-capped block grant, adjusted for inflation, state gross domestic product, state population growth, state Medicaid population growth, and other economic and demographic factors, for the duration of the waiver.”
  • Would require the joint commission on public assistance to review and hear testimony regarding the waiver seeking to govern Missouri’s Medicaid program that would be “patient-centered, sustainable and cost-effective approach to a market-based health care system that emphasizes competitive and value-based purchasing,”

Bill language also opens the door for the state to request work requirements, higher copays and health savings accounts as part of a revamped Medicaid program.

The Missouri Hospital Association testified in favor with all other testimony in opposition.  The bulk of the opposing testimony related to concerns that block granting Medicaid would shift costs to the state and result in cuts in services, disenrollment or waiting lists for potential enrollees.  No vote was taken on the bill but may be taken up by the committee as soon as next week.

A companion bill has been filed in the House by Budget Chair Scott Fitzpatrick.

About the Author

Leave a Reply