Health care access

St. Louis Post-Dispatch

Across the country, states are experimenting with strategies to provide health care to millions of people who don't have health insurance:

* Massachusetts lawmakers approved an ambitious bill designed to cover 90 percent to 95 percent of the Bay State's uninsured residents. Republican Gov. Mitt Romney supports the bill.

* Illinois Democrat Gov. Rod Blagojevich wants to offer affordable health coverage for every child and for thousands of low-income working families.

* Oregon's former governor, John Kitzhaber, an emergency room doctor, is crafting a universal coverage plan he hopes to float at next year's legislative session.

* Maryland requires big employers to provide health coverage to workers or pay a steep tax. New York and New Jersey may follow suit.

* Oklahoma and Arkansas have plans to subsidize insurance coverage for low-income workers.

But while other states are trying to create systems that protect more of their uninsured, Missouri lawmakers simply have taken a bone saw to the Medicaid rolls. The Legislature amputated health coverage for about 90,000 poor, elderly and disabled people during the last 12 months. In addition, about 20,000 Missouri children lost their Medicaid health coverage because their parents couldn't afford higher premiums. About 600,000 Missourians were uninsured in 2003-04, before the latest round of cuts of Medicaid rolls. ...

It's too soon to know whether Massachusetts' experiment will work. Without a dedicated source of revenue, there may not be enough money to pay for the program. That's precisely what happened when Massachusetts passed a universal coverage bill in 1988 but didn't fund it.

None of these plans is perfect, but out of all these state experiments, a workable national model may emerge. Missouri lawmakers should take note: Somewhere out there is a practical and affordable alternative to amputation.