Outlook: State Legislature: Health care issues top state legislative agenda

The 2001 legislative session began Jan. 3 and is scheduled to end May 18. This session there will be a number of legislative proposals that will directly affect Missourians and Missouri business.

Many of these proposals were filed last year but failed to gain final passage.

One of the most important issues facing the Missouri General Assembly will be the apportionment of Missouri's share of the Master Tobacco Settlement funds.

As a result of the efforts of Missouri Attorney General Jay Nixon and other attorneys general across the United States, the tobacco industry has agreed to a multibillion-dollar settlement with the states.

This settlement was to offset the cost states have paid for health care expenditures for smoking-related illnesses. Missouri's share of this settlement will be approximately $6.7 billion over the next 25 years.

The debate in Jefferson City centers on how these funds will be used. Some legislators argue that these funds should be refunded to Missourians, while others argue that the funds should be utilized for health care costs and smoking cessation.

Since Missouri has one of the highest smoking rates in the nation, it is imperative that Missouri do a better job at reducing the number of people that start smoking especially young people.

Last year's proposal allowed this issue to go to a vote of the people to make the decision of where these funds would best be utilized. If passed this year, this measure would be on the ballot in either August or November 2001.

Health care and prescription drug costs will be another high-priority issue in the 2001 General Assembly.

Last year, legislation was offered to allow small businesses and farmers to buy into the state health care plan, which would allow small businesses and farmers to obtain health insurance at rates lower than what they could get on the open market.

This pooling concept has allowed health care services to be available to small businesses at a lower rate and therefore has met with some success in other jurisdictions.

A number of proposals will address the rising cost of prescription drugs.

There is particular concern for elderly Missourians and the hardship that the high cost of maintenance prescription drugs creates.

The state has a vested interest in making sure low-income elderly Missourians on maintenance drugs are able to afford these prescription drugs and are not forced to decide whether to buy food or fill their drug prescription.

There also will be legislation to continue to make HMOs more accountable.

We will continue to make sure that preventive procedures and health screenings are available and covered under most managed care plans.

Last year, the General Assembly failed to pass legislation regarding elder abuse and neglect.

This legislation is aimed at improving the quality of care that elderly Missourians receive in nursing homes, from home health care providers and from family members.

This legislation grew out of an interim committee, which heard testimony throughout the state of Missouri from a variety of individuals concerning the abuse and neglect of Missouri's elderly citizens. A number of proposals were incorporated in this legislation last year.

The bill coordinated the efforts of law enforcement and the Division of Aging staff to assure prompt investigation of elder abuse and neglect claims, increased the asset limit for persons who qualify for Medicaid assistance from $1,000 per person to $4,000 per person, and increased penalties for those persons who abuse or neglect elderly persons in their care.

Missouri's current asset limit is the lowest in the nation and has the unintended effect of forcing some elderly Missourians into nursing homes because of financial considerations rather than because of health problems.

This results in Medicaid paying the full cost of nursing home care at a much higher cost to the state.

Another issue that will be addressed in this session is highway construction and the continuing maintenance of Missouri's roads and bridges.

An issue this year concerning highway funding also involves reducing Missouri's maximum blood alcohol level from 0.1 to .08.

Recent federal legislation requires states to enact .08 as their per se limit for driving while intoxicated or risk losing a percentage of their federal highway funds.

If Missouri does not enact the .08 blood alcohol limit, the state may eventually lose up to $34 million per year in federal highway funds.

The American Medical Association indicates that a driver is physically impaired at .05 and therefore, Missouri's current 0.1 standard is not in keeping with the safety of the motoring public.

This issue has met with significant opposition from various interest groups in past sessions, and that opposition will likely continue this year.

(Craig Hosmer is 138th District representative to the Missouri General Assembly.)