Senate Bill 28 would allow Missouri to ask the federal government for a block grant to pay for its Medicaid program, MO HealthNet, each year. The way things work now, the federal government picks up a portion of the cost of care for all of the services provided to Missouri citizens enrolled in the state’s Medicaid program. Advocates for Senate Bill 28 say that the block grant, which delivers a set amount of money each year, would help to reduce health care costs to the state and give the state more control over how, and where, the program uses the money. Proponents argue that a block grant could end up restricting care for those who need it most because once funds are used, or as covered services are eliminated, access to vital care is eliminated.
The bill does not outline how much money Missouri would request in a block grant or how much it would increase over time. It’s estimated that it would cost the state more than $400,000 annually to apply for the grant.
There are almost 1,000,000 low income Missourians covered through MO HealtNet. Income eligibility is the primary coverage determination and almost two thirds of those covered are children.
It seems logical that a block grant approach will require the state to reduce Medicaid coverage because funding is capped. Cuts in funding will lead to reductions in access to care. As access to care decreases it could drive more Medicaid patients to seek care in the Emergency Department setting which could drive cost to the state and place an undue burden on hospitals.
Funding Medicaid at the state level is a challenge and consumes a significant portion of the state budget. A block grant will guarantee funding from year to year but at what cost?
When it comes to health care, cost can’t simply be measured in dollars and cents, cost is measured in lives and quality of life.
Block grant to fund Missouri Medicaid, cup half full or half empty?