Insure Missouri buried in last week of session

JEFFERSON CITY - The Missouri legislature's two leaders on health care legislation are taking somewhat different takes on the prospects for the 2009 session of efforts to expand health care coverage for the lower income.

The Senate sponsor -- Sen. Tom Dempsey, R-St. Charles, said he plans on starting over next session and pre-filing before the start of the session. Dempsey suggested his new bill would be similar to his Senate-approved plan.

Dempsey's bill essentially provided low-cost health insurance coverage for the lower income who do not have health insurance.

"I'll pick up where I left off," said Dempsey, who is seeking re-election this year. "I'll look at the Senate sub as a good starting point."

Although filed late, Dempsey's measure won easy approval in the Senate. In the House, however, the measure was stalled from a dispute over whether to include provisions to ease state regulation over expansion of medical facilities.

"Instead of filing a bill on the last day of session like we did this year, we'll be able to prefile a bill and get the process started earlier," Dempsey said.

The House sponsor, however, has a much different attitude.

Rep. Robert Schaaf, R-St. Joseph, said he will be less involved in the process next year.

"The budget is going to be tight next year. The entire makeup of the political landscape is going to be different," Schaaf said.

Schaaf said the decision to draft legislation this year was based on the governor. "This was forced on us by Gov. Blunt with his Insure Missouri plan. We followed through by virtue of commitment to the governor to make a good faith effort on a bill we could support. We did that."

Schaaf chairs the House Healthcare Transformation Committee that handles many of the major health care measures in the House. A practicing physician, Schaaf had led the fight to include in Insure Missouri changes in the legal restrictions on hospital expansion -- a provision called "certificate of need."

Schaaf refused to allow the Senate-passed plan to come before the full House without those changes. He argued competition would help bring down medical costs.

Some, including the Missouri Hospital Association, blame Schaaf for slowing down the bill, and, ultimately, keeping it from passing.

"He's using Insure Missouri to drag it out," said Dave Dillon, a spokesperson for the association.

"I think Rob was leveraging Insure Missouri to get certificate of need reform addressed," Dempsey said.

The bill was held hostage in Schaaf's committee as he baited the bill trying to force the Hospital Association to come to the table and negotiate on certificate of need changes. Schaaf said the group's "political muscle" was too strong to pass a measure without them.

The bill was finally voted out of committee on Tuesday, but too late to come before the House.

"Well, I think it got Schaafted," said Sen. Wes Shoemyer, D-Clarence who voted for Insure Missouri. "Any expansion of health care I support. The good part of it not passing is I truly believe there is a better plan we can come out with," Shoemyer said , referring to better spending of Federal money.

Shoemyer echoed Schaaf's statement about a tight budget for next year. "The budget is going to be a tough place to be next year," he said.

The economy even affected Insure Missouri this year, Dempsey said. "One of the things that hampered the bill was this increase in food and fuel prices, concern over the job market. That temporarily moved health care down on people's priority list."

Dempsey said he hopes next year's economy will have improved enough for Insure Missouri to stand a better chance recognizing the issue isn't going anywhere.

"The issue doesn't go away and neither does the burden," said Senate GOP Leader Charlie Shields, R-St. Joe. "We'll have proposals for years to come, but I was comfortable with (Dempsey's) version. It passed the Senate very easily."

The House was another story.