After 43 years, Medicaid update provides for Missouri's disabled

Missouri's Democratic governor Jay Nixon has signed a bill disability advocates say will allow Medicaid recipients to cover their health needs while still saving money for emergencies, raising recipients' assets limit to help promote their independence. 

The bipartisan legislation gradually raises the savings limit for elderly and disabled Missourians on Medicaid from $1,000 to $5,000 per person, or $10,000 for couples, by fiscal year 2021. The bill's sponsor, Rep. Kevin Engler (R), said he worked on the bill for years after hearing of budget struggles among his constituents, Kevin Jenkins reported for the Daily Journal Online.

"When I was in the Senate, I had a constituent in De Soto who was a paraplegic who owned a small home, and he had an old van with 150,000 miles on it that could accommodate his wheelchair," Representative Engler told the Daily Journal Online. "He'd call me every two or three months and say, 'Senator Engler, I have to fix the van. Do I eat or fix the van?' He was calling just to make his point."

The law updates one passed in 1973, Engler said, and is designed to fix the unexpected problem of people with disabilities being unable to save enough money to pay for periodic needs, such as house or wheelchair repairs, without losing their regular health care, Mark Bliss reported for the Southeast Missourian. 

"These are folks who just want a chance to be responsible and save for the future, but a law written more than 40 years ago wouldn't let them. Today, we're doing something about that," Governor Nixon said when he signed the bill Thursday.

The law is expected to increase Medicaid enrollment by 10,000. The spending limit rises on a graduated scale until fiscal year 2021, a compromise for legislators who worried about the law's impact on the state budget. In July 2017, the limits will first be doubled, to $2,000 for individuals and $4,000 for married couples. 

"It something that I'm sure we would all love to be able to do in an environment where we have the money to do it," Rep. Eric Burlison (R), one of eight who voted against the bill, told the Associated Press. "My concern is that we can barely afford Medicaid right now."

Legislative researchers estimated the increase will cost the state $45 million annually once fully implemented, but the bill's sponsor insisted the cost would be lower because enrollment would decrease. Either way, he said, it will help people on Medicaid live better lives. 

Missouri's struggle to balance its budget with the hope of independence and care for the disabled has occurred in various states and at the federal level. Although the Americans with Disabilities Act is 25 years old, the work of accommodating unexpected side effects – and new technology – continues.

In 2015, the federal government passed the Steve Gleason Act so insurance would continue to cover speech-generation devices amid changes to Medicaid, The Christian Science Monitor reported previously. 

The law's namesake was Steve Gleason, the former New Orleans Saints football player who was diagnosed with a serious debilitating illness in 2011. He wrote that speech-generation devices, such as the one designed by Microsoft to help him type using eye movements, literally give a voice to the voiceless.