JEFFERSON CITY - Sen. Chuck Purgason (R-Caulfield) has a problem with Medicaid.
"The system we've got here sucks," Purgason told a Senate committee Monday. He was there presenting a bill that would eliminate a number of state health services, including coverage for expenses related to dental work, podiatry, wheelchairs, eye care and prosthetic limbs.
The bill, SB 539, is a companion to Gov. Matt Blunt's proposed budget. Blunt's plan would toss nearly 90,000 elderly and adult Missourians off of Medicaid rolls. Together they're part of a Republican push to overhaul a state program the governor said Missouri can "no long afford."
Medicaid is a joint program between the federal and state government that provides health care to low income, elderly and disabled citizens. It currently covers nearly 1 million Missourians and accounts for a quarter of the state budget.
In addition to slashing services, Purgason's bill would:
>> Cut 9,529 people from Medicaid rolls by ending the Ticket to Work program, which provides benefits to disabled citizens with a part-time job.
>> Order an annual audit of the eligibility of all recipients, who would be required to provide proof of their income or risk losing coverage.
>> Open the door for recipients to be charged co-payments for all services.
>> Relocate the state prescription drug program to the social services department.
Government estimates say the changes would save $166 million in general revenue next year, $115 million in 2007 and $87 million in 2008.
Dozens of disabled citizens came to the Capitol Monday to protest the measure. They crowded the hallway outside the hearing room for most of the day.
Inside, supporters and Republican committee members defended the cuts. They say the eligibility increases of the 1990s placed a costly emphasis on quantity over quality.
"Putting more people on government assistance was seen as a success," said Melinda Shepherd, an social services employee from St. Louis.
The committee chairman, Sen. Jason Crowell (R-Cape Girardeau), said major changes are needed to weed out waste.
"We've had a system that measures compassion by how many people can get on the rolls," Crowell said. "The fundamental question is whether or not people qualify."
"It's going to take human beings to do that," countered Sen. Pat Dougherty (D-St. Louis), a vocal opponent who said current attempts at ferreting our fraud were going understaffed. "I don't think we have the funds."
Opponents say the human cost of cutting the rolls is too high a price to pay.
Bob Pund, of Columbia, told the committee he was paralyzed in a car accident in 1989 when he was 20 years old. Medicaid paid for his wheelchair.
"This isn't cutting the fat out of things," Pund said. "This is cutting to the bone. This is almost like putting a bullet in someone's head. To get your health care taken away is dehumanizing."