Observations from a Medicaid Committee Hearing – Kennett, MO

By: Megan Baker, PharmD Candidate, 2014
Summer 2013 MPA Rotation Student

As a 6th year pharmacy student on rotation with the Missouri Pharmacy Association, I had the opportunity to attend a committee meeting to hear public opinion on Medicaid expansion. The committee consists of 50 legislators, healthcare providers and citizens who visit different areas of Missouri to learn about the public opinion on the expansion of Medicaid under the Patient Protection and Accountable Care Act (referred to as ACA). People from the community are able to witness to the committee about their opinion on the Medicaid expansion.

I can tell you that as a student I did not know much about Medicaid. I knew that copays didn’t exceed $2 for participants and that in order to qualify you had to have little to no income. I did not know that pharmacies are provided a dispensing fee of $4. I also did not know that there could be tiers of coverage in the Medicaid system. Some people will not have any copays or premiums to meet monthly while others have higher copays and premiums to meet, which extends beyond the pharmacy benefits they receive.

I attended the committee hearing in Kennett, Mo., which is part of Dunklin County in the bootheel. Dunklin, along with its neighboring county Pemiscot, have the highest percentage of Medicaid recipients in the state of Missouri. Included among the people that testified to the committee were healthcare administrators of the hospitals, concerned citizens and even a few committee members. Most people in attendance were for the expansion or reform of the current Medicaid system.  One person in particular was for the expansion because he was having trouble paying his bills for the month after he meets his out of pocket expenses required by new Medicaid regulations. He also stated that he worked all his life and gave back to the community when he could so when he needed help he was not afraid to ask. Most of the stories and information given by the participants were for Medicaid expansion due the benefit of the communities and residents that may include more jobs for citizens and more people covered under the expansion.

It was definitely a different experience for me. It was an opportunity to see beyond the counters of a community pharmacy experience with Medicaid recipients and into a more comprehensive view of the people we provide with pharmaceutical care.

The Medicaid system was established in 1965 as an amendment to the Social Security Act. Medicaid is currently financed with state and federal funds. If state legislators approve the expansion, it will be 100 percent financed by the federal government from 2014 – 2016 with decreasing funding for the following years. Funding will be lowered in increments to 90 percent by federal government over the next eight years. States are required to cover children, qualified parents, and pregnant women with low income, older adults and low income people with disabilitie. Under the expansion of Medicaid, more people will be eligible for coverage with a predicted 200,000 Missourians gaining healthcare coverage. According to some reports, Medicaid expansion under the ACA is expected to bring approximately 24,000 jobs into Missouri communities.

Missouri does have the ability to opt-out of the expansion due to a Supreme Court ruling, which would mean declining the additional funding from the federal government provided under the ACA. Currently, expansion has not passed in the state of Missouri and there is no deadline for opting in or out per the federal government. To learn more about the economic aspects of Medicaid Expansion in Missouri, you can review the University of Missouri’s study The Economic Impacts of Medicaid Expansion on Missouri.


Megan K. Baker
Missouri Pharmacy Association Rotational Student
PharmD Candidate 2014
St. Louis College of Pharmacy

 “The Missouri Pharmacy Association promotes the role of pharmacists in patient care relationships as the medication expert.”

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