JEFFERSON CITY - The debate over Gov. Matt Blunt's proposed cuts to Missouri's health care programs for the poor hit the floor of the state Senate Monday.
The Democratic minority blocked action by staging a filibuster against a bill designed as a companion to Blunt's proposed budget, which sought to knock nearly 90,000 people off of Medicaid. The stalling tactic went on into the night with no resolution reached as of press time.
Medicaid is a joint program between the federal and state government which provides health care services to the poor, elderly and disabled. It covers 1 million Missourians and accounts for a quarter of the state budget.
The bill before the Senate was sponsored by Sen. Chuck Purgason (R-Caufield). It would:
>>Slash a number of state services, including coverage for expenses related to dental work, podiatry and eye care. It would also halt funding for wheelchairs and prostethic limbs.
>>End in-home care for some disabled people and place the remainder of services under the Department of Health and Senior Services.
>>Cut 9,529 people from Medicaid rolls by eliminating the Ticket to Work program, which provides benefits to disabled citizens with part-time jobs.
>>Order an annual audit of the eligibility of all recipients, who would be required to provide proof of their income or risk losing coverage.
>>Open the door for recipients to be charged co-payments for all services
>>Relocate the state prescription drug program to the Department of Social Services.
It does not contain the core cuts in eligibility sought by Blunt, which are currently working their way through the House budget process.
The Democrats took the opportunity to speak out not just against Purgason's legislation but also the governor's larger budget cuts.
Sen. Pat Dougherty (D-St. Louis City) was quick to bring up Blunt's comment during his campaign last year that any cuts to eligibility would be "inappropriate" until waste, fraud and abuse had been rooted out of the system.
"Do we have a problem?" Dougherty asked. "Darn right we do. But we don't throw people off first then work to solve the problem. I do not consider these individuals as expendable to balance our budget."
Republicans say the cuts are necessary to rein in a program they describe as out of control. Blunt has said the cuts are the only way to avoid raising taxes or cutting education funding.
"Without reforms, this system will die," said Sen. Jason Crowell (R-Cape Girardeau). "The red flags are waving, the alarm bells are blaring."
Throughout the 1990s, Missouri's Medicaid rolls swelled. When the late Democratic Gov. Mel Carnahan took office in January 1993, just over 510,000 Missourians were enrolled in the system. According to the state's latest estimates, nearly 1 million are covered today. The program's $4.8 billion price tag accounts for more than 28 percent of Missouri's total budget.
House Republicans last week put forward more modest cuts than those pushed by Blunt. They would require some families pay premiums in order to restore eligibility cuts planned for the elderly and disabled and fund psychiatric and drug abuse treatment.
Another bill in the Senate would establish a panel to deliberate and propose a new entirely new structure for the state's health care system.
The tactic of freezing action on the Senate floor through extended debate is known as a filibuster. Unlike House members, Senators may speak for as long as they wish. The filibuster is typically used by a minority to prevent a vote on a bill which appears to have majority support. A constitutional majority of Senators could move to shut off debate and force a vote but the measure is rarely used. On St. Valentine's Day, Columbia Sen. Chuck Graham's failed attempt at blocking a name change for Southwest Missouri State University stretched into the early morning hours.
The proposed cuts and all the rest of the budget must be worked out by May 6, the last day of the session, when the government is legally required to have a budget finalized. As of Monday, an operating budget had not been formally submitted. Last year, the official budget was in the House by mid-February. Despite the lag, Speaker Pro Tem Carl Bearden (R-St. Charles) says there's no reason to worry.
"We not behind unless we don't get it done by May 6," Bearden said.