Catholic Charities of St. Louis is opposing Senate Bill 28, which requires the Missouri Department of Social Services to apply to the federal government for a Medicaid global waiver.

The waiver would include provisions that propose or accept funding mechanisms similar to a federally capped block grant.

It is designed to give the state flexibility to implement a market-based health care system that emphasizes competitive and value-based purchasing. It might include eligibility determinations that include work requirements for certain able-bodied adults; initiatives to promote healthy outcomes and personal responsibility, including co-payments, premiums and health savings accounts; the use of selective contracting and competitive bidding, preferred provider networks, and health outcome-based provider reimbursement; and accountability and transparency measures.

Catholic Charities and some other social service groups believe the measure could dramatically alter Missouri's Medicaid program and jeopardize health services for seniors, children and people with disabilities, including mental illness.

Tamara Kenny, director of advocacy and community engagement at Catholic Charities, said the broad changes for eligibility and cost savings "are a concern for us at Catholic Charities. The block grant raises a host of other issues if there's an increase in costs. They could end up cutting services. It's a very dangerous proposition for our clients."

Under the proposed bill, changes to the Medicaid program proposed in the application would receive final approval by a committee comprised of 10 legislators. There is no provision for submission to elected officials in the full General Assembly and the governor for final approval.

Currently, the federal government shares in the cost of administering the state's Medicaid program, contributing in most cases approximately 63 percent of every dollar spent without limitation.

Medicaid provides health coverage to pregnant women, children, low-income parents, people with disabilities and the elderly. Middle-class families often rely on Medicaid when an elderly parent enters a nursing home and their life savings become depleted, according to a statement from Catholic Charities.

Catholic teaching declares that access to health care is a basic human right. However, this same teaching indicates that people have some responsibility for their own health care and the health care of their families. In seeking to uphold these principles, the Missouri Catholic Conference has supported legislation that will both reform and expand the Medicaid program. The Catholic conference, however, has taken no position on Senate Bill 28.

The Catholic conference is seeking passage of Senate Bill 15, which would extend the sunset date on maternity homes and pregnancy resource centers to 2026 and 2025, respectively. These tax credits help charitable agencies that offer programs to women facing unplanned pregnancies raise more money. The Catholic Conference also testified for SB 217, which would extend the tax credit for donations to food pantries to include donations made to soup kitchens. 

>>What to do

For up-to-date information on Senate Bill 28, visit www.stlouisreview.com/bpW. To contact legislators regarding the bill, visit www.stlouisreview.com/bpZ.

To follow positions taken by the Missouri Catholic Conference on legislation, visit www.mocatholic.org.