INJURE MISSOURI

The last time ideology masqueraded as health policy in the Missouri
Legislature, more than 100,000 poor, elderly and disabled people lost insurance
coverage.

Here it comes again.

In the crosshairs this time are thousands of low-income, uninsured parents who
would have received coverage through Insure Missouri, the program proposed last
fall by Gov. Matt Blunt. A trio of bills now moving through the Missouri House
would keep coverage out of their reach.

At least some of the politicians who voted for the disastrous 2005 Medicaid
cuts — which sent the number of insured people in our state soaring at triple
the national average — appear to have learned something from their mistakes.
That seems to be the case with Mr. Blunt, whose plan would have restored
coverage to about 52,000 of the more than 100,000 people who lost it.

Mr. Blunt plan was forced to withdraw the Insure Missouri plan this year after
legislators objected. A new version proposed by the House might as well be
called “Injure Missouri.”

State Reps. Robert Schaaf, R-St. Joseph, and Doug Ervin, R-Kearney, wrote the
House plan. It’s spelled out in a committee substitute for House Bills 2355,
2394 and 2413.

Their proposal would cover fewer people, at a higher cost per person, than the
governor’s proposal. Where Mr. Blunt’s plan was simple, their version is
unwieldy and complex. Administering it would require a large new bureaucracy.

Instead of giving uninsured people coverage through a large group policy, as
the state does for its employees and people who qualify for Medicaid, the House
plan would force them to buy individual policies. That’s problematic for three
reasons:

First, individual policies are much more expensive than group coverage. Second,
insurance companies selling individual policies have great leeway to refuse to
cover people with prior health problems — and the companies do so routinely.

Third, insurance works most efficiently when risks are pooled among a large
group that includes both healthy and sick people. Forcing people into
individual policies negates that advantage, so coverage is costliest for people
who need it most. It also allows insurance companies to “cherry pick” the
healthiest people, leaving taxpayers to cover the sickest and most expensive.

Another problem with the House proposal: People whose employers offer health
insurance — even if the coverage is too expensive to afford — would not be
eligible. And only people who had been uninsured for at least six months could
enroll.

Once they did, they’d have to make payments into a health savings account. They
would have to meet a deductible of between $1,000 and $2,500 before coverage
would begin. For families living at or below poverty, including single parents
raising two children on just over $3,500 a year, that’s unconscionably high.

As we said at the time it was introduced, Mr. Blunt’s version of Insure
Missouri was far from perfect, but it would have been a step in the right
direction. It would have provided meaningful coverage to about 52,000 uninsured
parents right away and to nearly 150,000 others within the next several years.

The House version of Insure Missouri is inadequate and unworkable. It should be
voted down in favor of an alternate bill now in the Senate. Missouri already
has seen what happens when ideology is substituted for sound policy. We don’t
need an instant replay.