- Associated Press - Tuesday, January 20, 2015

JEFFERSON CITY, Mo. (AP) - A Missouri Republican proposed expanding Medicaid coverage to low-income military veterans and their families Tuesday as a slimmed down alternative to a broader Medicaid expansion that has been opposed by many of his GOP colleagues.

The bill by Sen. Ryan Silvey would expand Medicaid coverage for veterans and their families making up to 138 percent of the federal poverty level, which is $29,685 for a family of three.

“The other proposals that I have will cover not only veterans but everyone, but I felt it was important to try and solve this problem for this group,” Silvey, R-Kansas City, said.

Missouri is one of 23 states that has not used a provision of President Barack Obama’s health law to expand Medicaid, a joint federal and state program that provides health care to low-income individuals. Missouri’s Republican legislative leaders have said there’s little chance for any expansion this year.

As part of the federal Affordable Care Act, states that expand Medicaid coverage for families and individuals making up to 138 percent of federal poverty can receive more federal funding.

Currently, able-bodied adults without children do not qualify for Medicaid in Missouri. Parents making less than about 19 percent of federal poverty, or $3,612 for an adult with two children, do qualify.

Many working Missourians fall into what Silvey and others call a coverage gap, making too little to qualify for subsidies to pay for insurance through a government exchange, but too much to qualify for Medicaid. This includes working age adults under 65 making less than $11,670 for a single person.

Silvey said early estimates were at least 22,000 spouses of veterans would qualify for Medicaid under the proposal.

Dewey Riehn, Veterans of Foreign Wars legislative chairman, said expansion would benefit many veterans and their families. Veterans might already be covered through programs run by the U.S. Department of Veterans Affairs, he said, but “there is nothing for the family.”

Riehn said he personally supported full expansion of Medicaid but that his group works specifically on behalf of veterans.

Even a bill aimed at assisting veterans may not have enough support to move forward in the Legislature.

“I think the opposition is more fundamental than who it goes to,” said Sen. Ed Emery, R-Lamar. “My concerns would be the same.”

Emery said he agreed the government should take care of those who served in the military but said he thought that should be done through specific veterans’ programs.

Silvey said Missouri has already expanded Medicaid in other ways, by adding services such as dental care, and has considered whether to increase the amount of money and other assets that individuals can save and still qualify.

“If we’re already OK with having the debate of increasing the asset limit, or adding back procedures that were recently cut … we ought to be putting money into taking care of our veterans,” Silvey said.

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