Lichtenegger on Medicaid no vote: Somebody's always going to be poor

(In her weekly report, Rep. Donna Lichtenegger, R-Jackson, explains why she voted against the Medicaid expansion- there are always going to be poor people and you have to draw the line somewhere.)

 For many years now Missourians have recognized that the Medicaid program needs reform. In fact, it’s so terrible that doctors nationwide have publically said they will no longer take on new Medicaid patients. Furthermore specialty care, which is expensive and often crucial to treating our medically underserved, is limited by Medicaid’s burdensome federal regulations and requirements.   Medicaid is failing in at least three areas: cost to taxpayers, access for the underserved and healthy outcomes. 

     We must face these difficulties with political courage and perseverance in order to produce a solid, viable, long-term solution. In other words, we should cure the wounded program, not just put a fiscal bandage on it.  The program Governor Nixon proposes will significantly increase the already massive Medicaid state budget dollars which stands at $8,495,897,923 (yes, that is more than 8 billion dollars!) for the fiscal year 2013 for 957,211 Medicaid-eligibles.  Even if we take out the federal-fund contributions (which we still pay for with federal taxes) the number is still more than $4 billion in state revenues. A genuine, wise and efficient Medicaid program reform should result in improved systemic operation, healthier Missourians and a substantial taxpayer-dollar savings.

     Republicans and Democrats in Florida, Louisiana, Kansas, Texas, and Wisconsin have noticed Medicaid’s vast shortcomings.  Instead of just throwing more money at the problem, these states have offered realistic solutions.  With a pragmatic approach, they have instituted reforms that have promoted stronger patient outcomes, increased doctor participation, and reduced burdensome restrictions on delivered care.  We can bring those solutions to Missouri and that’s what many legislators are working toward this session.

     Because we all want to see those who have a genuine economic need receive it, the issue of serving them is obviously an emotion one. But the rhetoric that those of us who push for reform hear is that we don’t care about them. This is the uninformed and therefore irresponsible message coming from a few media sources and blog comments. The frightening truth is if we do not produce an efficient, stable, reformed Medicaid we will find ourselves in a bankrupt state that cannot serve but a select few!

    There is another factor to consider: There will always be someone just above the eligibility “line” no matter where you draw it. Someone will always be “the poor among us”. As a generous, “civilized” society we can do our part in our communities to assist for the greater good. Tally up the number of non-profits both state and nation wide and you will be pleasantly surprised at the great number that exist, and you will be further surprised at the number of persons they serve. Take Lutheran Family & Children’s Services (LFCS) as an example. There are four regional offices that cover the entire state of Missouri. If you visit their website you’ll notice that they have 11 major programs each of which provide countless services. Organizations such as the LFCS not only provide significant services and support they really save Missouri taxpayers a lot of money. The Missouri Department of Social Services will concur with that statement; I know this first-hand because I’m on the Appropriations Committee for Health, Mental Health and Social Services. I encourage you to contact the Cape Girardeau Southeast office* and ask how many clients they serve on average per year, the various ways they serve/support them (goods and services) and ask them the average amount spent per client.  Even better go visit their facility and learn firsthand the benefits to those they serve. While you’re there how about volunteering your time and / or other resources? If you do this, you’ll begin to get a sense of how valuable are these non-profits.

      Having been myself involved with LFCS and Boy & Girls Club, I can testify that organizations such as these produce long-term positive outcomes for those who may otherwise have become a long-term poverty statistic.

      This is why the state House legislators recently passed (with near-unanimous bipartisan support) House Bill 87 that re-establishes or extends the sunset date on many Benevolent Tax Credits to December 31, 2019. The tax credits impacted by this legislation include the income tax credit for the surviving spouse of a public safety officer who has not remarried, the children in crisis tax credit, the disability access residential renovations tax credit, the pregnancy resource center tax credit, and the income tax credit for a donation to a food pantry.

     These tax credits encourage investments from private citizens for programs that benefit many of our most needy citizens. It will help many of our charitable organizations gather resources to provide much needed assistance to low-income families. These benevolent tax credits are a fiscally responsible way of assisting Missourians who are in need.

     Times are tough in Missouri and across our nation. However, encouraging private citizens to support the many charitable organizations who are providing much needed resources to pregnant women and hungry children is good public policy (and by the way they also employ a great many persons). It is not just the smart thing to do; it is the right thing to do.