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Mo. Legislators Propose Major Changes To State’s Healthcare System

A new health care proposal in Missouri would revamp the state’s Medicaid system, create more pricing transparency and offer incentives for physicians to work in underserved areas, among other changes. Identical state health reform bills (HB 1793 and SB 847) were introduced Monday by State Rep. Keith Frederick, R – Eureka, and State Sen. Rob Schaaf, R – St. Joseph.

The bill proposes a pilot program for revising Missouri Medicaid. Starting July 1, 2015, the program would set up health savings accounts for recipients.

For standard care and preventative medicine, Medicaid recipients would pay primary care physicians a set monthly fee of approximately $70 to $100 per month. Medicaid patients would then be permitted to see their physician as often as needed.

Funds would be provided to recipients on electronic benefits transfer cards, similar to “food stamp” payments.

Frederick and Schaaf say the proposed changes would reduce the cost and bureaucracy of the current fee-for-service and managed care systems.

The proposal also seeks pricing transparency by requiring insurance companies and health care providers to give cost estimates of services. It would also encourage doctors to work in underserved areas by creating a student loan forgiveness program for medical school graduates who agree to work as “temporary assistant physicians” in areas without adequate medical care.

Additional proposed changes include the creation of patient health information exchanges for physicians and measures designed to change what the sponsors describe as “anti-competitive issues” in hospitals.

The proposal was met with skepticism by some.

Thomas McAuliffe, Director of Health Policy for the Missouri Foundation for Health, said the bill offered some great ideas but did not do enough for many in need.

"This piece of legislation kind of nips at the margins of a couple big questions," says McAuliffe. "But there are some significant question that still need to be answered, namely - how do we insure the 850,000 uninsured in Missouri?"

Schaaf, who has been a strong opponent of the Affordable Care Act and Medicaid expansion, says the new proposal is “vastly different” from the federal law, even as it seeks to make health care more affordable for many low-income Missourians.

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