If it were put to a simple up-or-down vote today, Missouri lawmakers probably would agree to extend health insurance coverage to about 55,000 working parents who are struggling to raise their children.
But that’s not going to happen. Extending health insurance to poor parents through a program called Insure Missouri has gotten mixed up with some controversial and largely unrelated issues. Because legislators want to score political points and push through unpopular ideas, thousands of working poor parents will have to make do without regular health care.
It’s not too late to provide them with coverage. But doing so would require two important House leaders to compromise on pet causes. With just days remaining in the legislative session, neither appears willing to back down, and coverage for poor parents seems doomed.

The tragic irony is that the leaders’ issue has some merit. It involves changes to the process for winning state approval — called a Certificate of Need, or CON — to build expensive hospital, nursing home or medical facilities.
But there is no consensus on exactly what needs to be changed. Inclusion of CON in the insurance expansion bill, along with technical language added by the House that would limit the state’s ability to get new federal Medicaid money for expanding coverage to uninsured parents, is the main stumbling block to winning approval.
Insure Missouri first was proposed last year by Gov. Matt Blunt. But his version no longer is on the table; both the House and Senate have passed their own versions of the program.
House Speaker Rod Jetton, R-Marble Hill, and Rep. Robert Schaaf, R-St. Joseph, who chairs the Special Committee on Healthcare Transformation, have said they won’t allow a vote on a bill that doesn’t include CON reform.
They want to require that testimony before the Missouri Health Facilities Review Commission, which issues CONs, be delivered under oath and that commissioners limit their decisions to matters discussed during testimony. Those aren’t horrible ideas. But the Missouri Hospital Association and the St. Louis Area Business Health Coalition, a group of large companies that provide insurance to their employees, oppose the CON reforms. Their opposition probably dooms the bill.

Also absent from the Senate bill is language, written by Mr. Schaaf, that would limit the amount of federal money provided to expand health insurance. Mr. Schaaf argues that without such limits, insurance would become “an entitlement” owed to anyone who meets income and eligibility guidelines. Horrors.
Mr. Schaaf remains confident that an agreement can be reached before the Legislature adjourns on Friday afternoon. Others say that won’t happen unless he and Mr. Jetton agree to allow a vote on the Senate version of Insure Missouri.
The bill’s failure would be tragic for working poor parents. It would also be a problem for legislators who’d have to explain to voters why they let this opportunity to reduce the number of uninsured Missourians slip through their fingers.

(Post-Dispatch file photo)