JEFFERSON CITY, Mo. — Todd Foltz once had a job with health insurance. He lost that as his multiple sclerosis continued to worsen.
With medicine costs of around $5,000 a month, Foltz told lawmakers Tuesday that he desperately needs health insurance. Yet he said he earns too much to qualify for Missouri's Medicaid program and too little to get subsidized insurance through a new federally run marketplace.
"I fall squarely in the Medicaid gap," said Foltz, 44, of Kansas City. "For me, it's becoming not just a gap but a crevasse, and it's becoming not just frightening but terrifying."
Foltz was among about two dozen low-income residents, pastors, business leaders and health care advocates who testified Tuesday in support of legislation that would expand Medicaid eligibility to about 300,000 people living in or near poverty. States that do so can receive billions of additional federal dollars under President Barack Obama's health care law.
Business officials said the influx of federal money into the health care industry could help the economy. Religious leaders described Medicaid expansion as a moral imperative.
Yet Missouri's Republican-led Legislature has repeatedly rejected Medicaid expansion proposals over the past two years and shows little inclination of embracing one now. Several hours after the public testimony on a Medicaid overhaul bill, the House defeated an attempt Tuesday to insert $1.7 billion of federal funds into next year's budget to accommodate a Medicaid expansion.
House Speaker Tim Jones has said it appears unlikely that legislators will pass a bill expanding Medicaid eligibility.
"Expansion is simply something that the Legislature does not have much of an appetite for this year," said Jones, R-Eureka.
Many Republicans cite concerns about the potential long-term costs to the state budget of expanded Medicaid rolls.
Missouri's Medicaid program currently covers about 830,000 people at an annual cost of nearly $9 billion, most of which comes from the federal government.
In 2005, Missouri pared back its adult Medicaid eligibility levels to the lowest income thresholds allowed under federal law — about $4,500 for a family of four. The House legislation attempts to draw down about $2 billion annually in federal dollars by raising that Medicaid eligibility threshold to 138 percent of the federal poverty level, or nearly $33,000 for that same family of four. The House legislation would use Medicaid dollars to buy health insurance policies through a federally run online marketplace for some of those newly enrolled adults.
Like Foltz, others who testified Tuesday before the House Government Accountability and Oversight Committee said they don't qualify for Missouri's current Medicaid program even though their incomes fall below the poverty level.
Jeri Landon, of Sunrise Beach, said she is a cancer survivor who is working 30 hours a week while also taking a full college course load and providing for her disabled husband, a disabled adult daughter and a 17-year-old grandson. Without health insurance, Landon said she chooses not to buy the $38-a-month medication she needs for her high cholesterol.
"Please do not make me and the many, many hardworking Missourians go any longer without health care," Landon said. "We need to expand Medicaid now."
Jamie Kanan, a 29-year-old divorced mother of five from Potosi, said she suffers from lingering pain as a result of previous domestic violence. Her income from two jobs puts her at about 39 percent of the poverty level — too much to get Missouri Medicaid coverage. Yet Kanan also cannot qualify for federal subsidies to buy insurance through a federal government website, because that aid is available only for people living above poverty.
"I could be an even better mom if I had health care," she told lawmakers. "To me, it's not fair that I can't get help. Medicaid expansion could give me the help that I need."