Citizens for Missouri's Children addresses health-care issues at forum

~ The forum attracted about 30 people including health-care providers and social services advocates.

A program that helps working parents keep health insurance for their children faces obstacles in Jefferson City, Mo., and Washington, D.C., as lawmakers deal with mounting medical costs, a children's advocacy group warned Wednesday.

At a public forum at the Show Me Center in Cape Girardeau, Citizens for Missouri's Children provided details of the challenges health-care providers are facing as they deal with Medicaid changes on the state level and outlined the competing proposals before Congress. The forum attracted about 30 people including health-care providers and social services advocates.

The State Children's Health Insurance Program, or SCHIP, has reduced the percentage of children without insurance nationwide by almost one-third since its inception in 1998. In Missouri, the program known as MC+ for Kids provides coverage to children in families up to 300 percent of the poverty level who can't find affordable health care through employers.

But changes in the state program in 2005, along with other Medicaid cuts, reduced the number of children eligible for services by 70,000, said Catherine Martarella, program director for group. Missouri lawmakers are working on a complete overhaul of Medicaid, but the bill doesn't restore coverage to many of those removed from the rolls, she said.

"I don't think that people in the communities know what is going on," Martarella said.

The coverage for many of the children isn't free. For a family of three with an income above $25,755, the state charges a sliding scale of up to 5 percent of income. But the restrictive Medicaid rules passed in 2005 have many providers scrambling to deal with additional paperwork while struggling to provide adequate care, said Robert Wissore, CEO of Concord Counseling and Rehabilitation Services Inc. in Sikeston, Mo.

"I've been in this business 30 years and I am as discouraged as I have ever been about providing mental health services for children," he said.

Wissore helps children with histories of abuse, behavioral problems and dysfunctional families. When a child is covered by Medicaid, he said, the state restricts the time he has to treat them in ways that make it difficult to improve the child's condition, he said.

"There are a lot of decisions made in Jefferson City and Washington and they don't know the kids I work with in Southeast Missouri," he said. "They didn't just cut people off -- they put in a bureaucracy that made it almost impossible to help them."

While Missouri lawmakers grapple with how Medicaid will look in the future, Congress must decide whether it wants to keep the SCHIP program. Federal funding supports a large portion of the program, and Congress is debating whether to keep the program, make it more restrictive or expand it for additional children. If Congress does nothing, the program will end next year.

The program will cost $12.7 billion over the next five years to maintain current coverage levels, Martarella said, and 1.5 million children will lose coverage by 2012 unless Congress increases spending.

Under the regular Medicaid program, states choose how generous they will be and the federal government provides matching funds. The SCHIP program is funded by block grants to the states, which must tailor the program to the available funds.

"There is a lot of need out there, and we need to watch what is happening in Washington and the state," Martarella said.

rkeller@semissourian.com

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