If you or a loved one has ever undergone the trauma of a serious unexpected illness, you need to watch the Missouri legislature over the next two weeks. The Republican-led House Special Committee on Healthcare Facilities has drawn up the Missouri HealthNet plan to overhaul Missouris Medicaid program, on which thousands of Missourians depend for basic health care.

I spoke before the committee Wednesday as a former small-business owner who had built my businesses at great risk to my financial security and, as I discovered, my physical health, as I could afford nothing more than catastrophic health coverage with extraordinarily high deductibles and co-pays.

At age 37, I received a stage 4 cancer diagnosis, requiring an intense and expensive treatment regimen. It was the Missouri Medicaid program that saved my life, enabling me to receive essential health care which should be the right of every American. Now that I have endured 18 months of treatment and drastic changes in my lifestyle enabling significant recovery, I am caught in a complex web of bureaucracy preventing me from returning to work.

The unusually strict Medicaid eligibility guidelines in Missouri will not allow me to move on with my life and return to my previous business, which is falling apart as a result. I am thus at serious risk of becoming permanently dependent on the state not only for health care, but for basic needs as a result.

HealthNets massive web of red tape, including several new bureaucratic entities which will require annual evaluations and constant oversight, can serve only to enrich a new network of political cronies, oversight of whom will cost much more than expanding Medicaid coverage and eligibility ever would. It does nothing to restore the coverage that was so cruelly taken away from over 100,000 poor and disabled Missourians by the Governors 2005 cuts. And HealthNet refuses to update Missouris unconscionably stringent eligibility guidelines, the second strictest in the county, which prevent a single adult with no children from earning even the paltry sum of $300 per month without losing his or her Medicaid health coverage.

I am also appalled by the HealthNet plans refusal to acknowledge the dignity of poor and underserved people. It treats us as deviant criminals, spending more effort on rooting out so-called Medicaid fraud than it does on providing health coverage. Health care should not be used as a political weapon.

Health care for all Missourians is a goal that is far too important to allow an ill-considered piece of legislation like Missouri HealthNet to rush through at the last minute in a vain effort to score political points. Increasing Medicaid eligibility and expanding coverage across the board would not only save the state money in the cost of care, it will bring in matching federal dollars that are added to the states health care budget. Expanding health coverage for underserved populations is a win-win situation for Missouri. Missouri HealthNet does precious little to expand health coverage, and is a horrendous example of out-of-control political bureaucracy. It is time to stop playing games with peoples lives and bring Missouris Medicaid eligibility guidelines into step with the rest of the country; we can do better.

Commentary by Melanie Shouse
Overland, MO

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