Report outlines potential crisis in state-funded care

The report, titled “Data Book 2: The Cost of Care for Missouri’s Uninsured,” should be of particular interest to newly elected and returning members of the Missouri General Assembly, who will be responsible for replacing Medicaid, the health care system for the lower-income in Missouri, by June 2008.

Among the key findings in the report is that in 2005 the cost of providing health care to uninsured Missourians ranged from $666 million to $753 million, while public sector revenue available to cover these costs was approximately $723 million. About 76 percent of these revenues came from the federal government.

The report also found that in the very near future, the cost of providing health care to the uninsured is likely to exceed the public funds available, for two key reasons:

• The costs associated with providing health care to the uninsured are higher than costs associated with providing health care to those with insurance. The higher cost of providing health care to the uninsured stems, in large part, from the fact that the uninsured forgo preventive care and seek health care at more advanced stages of disease, as they are often forced to choose between visiting a doctor and paying for other needs such as food or housing.

• Recent cuts to the Medicaid program in Missouri will increase the number of uninsured citizens in the state. The MFH study found that reducing the number of Missourians eligible for Medicaid will increase the demand for uncompensated care – health care provided to the uninsured by hospitals, physicians, clinics, and others without payment by the patient. Simultaneously, available uncompensated care subsidies – funding made available to these providers from Medicaid, Medicare, federal and state grants, and other government sources to offset the costs of providing uncompensated care to the uninsured – are unlikely to keep pace with the increased demand for services.

“In some ways, this is a simple economic equation,” said Leslie Reed, MFH Vice President for Health Policy, in a news release. “If the cuts in Medicaid enrollment stay intact or are deepened, then the demands placed on the health care system by Missourians without health insurance will quickly begin to exceed the supply of funds available to address their health care needs.”

Reed noted, however, that if the state considers expanding existing coverage eligibility guidelines, it’s possible that some expenditures for uninsured care could be redirected to cover new Medicaid costs.

The report is the most recent publication of the MFH’s “Cover Missouri Project,” which looks at the strengths and weaknesses of the current health care system in Missouri and explores options for decreasing the number of uninsured. The report was prepared by The Urban Institute.

An executive summary and a copy of the full report are available at the MFH Web site at www.mffh.org.[[In-content Ad]]