Letter to Editor from Cynthia Keele, Executive Director, NAMI

Persons with mental illness, their families and mental health workers were stunned by our governor’s Jan. 26 proposal to make drastic cuts to health insurance coverage/Medicaid and mental health treatment. While health care for children and pregnant women was spared, approximately $632 million will be cut from health care for disabled adults, poor seniors and low income parents will occur on July 1, 2005, if our governor’s proposals are approved by the Missouri House and Senate in May. While I am sensitive to the challenges the new administration faces and understand our state’s constitutional requirement for a balanced budget, it is hard for me to understand why our state’s budget should be balanced on the backs of those who are most in need of help.

The governor’s statement that Missouri has the second highest percentage of its budget going to Medicaid health care, while technically true, is misleading. It gives the mistaken impression that Missouri’s program is much richer than other states. It is not.

Missouri ranks 39th in funds spent on Medicaid health care. This is due in large part to the 17% of Medicaid costs supported by provider taxes. (Source: National Association of State Budget Officers, reported by the Missouri Hospital Association.)

Additionally, the Hancock limitations and our legislator’s failure to enact income producing measures widely adopted by other states keeps Missouri’s “money pool” for health care and other programs smaller than most. When the pool is small, the percentage a state spends on health care is larger.

The statistic quoted in the governor’s speech is like comparing apples to toasters. A per capita/per person spending comparison would have given a far more accurate picture of Medicaid in Missouri.

Missouri could choose to increase its income as other states have done. We could maintain health care for thousands by taking some simple measures such as enacting a higher excise fee on alcohol (we have not increased this fee in more than 30 years). We could raise the meager tax we charge on tobacco products. (Missouri has one of the lowest tobacco tax rates in the nation). We could also close tax loopholes that unfairly favor large out-of-state corporations (The Geoffrey Loophole, so named for the Toys are Us giraffe).

With one party more or less holding all the cards this year’s gridlock should not be a problem – this year. Helping people who have no chance of getting health care on their own is doable, if our elected officials will just choose to do it. Sincerely,

Cynthia Keele, Executive Director, National Alliance for Mentally Ill (NAMI) – Missouri’s Voice on Mental Illness