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Changes to the MC+ program will affect more than 46,000 children

Lane DePrima Jacobs, Project Dir., RWJ Covering Kids & Families MC+ Statewide Coalition and Brenda Procter, Consumer and Family Economics, University of Missouri Extension

As we know, the Missouri legislature made many changes to the Medicaid/MC+ program. Most of the changes affect adults, and they have been widely covered in the media; however, the children’s program changed significantly as well. Because changes don’t fall into the “cuts to eligibility and benefits” category, they have received little attention. That is unfortunate because in states that have instituted similar premium programs, roughly 50 percent of recipients lose coverage. That could mean an additional 20,000 uninsured children in Missouri.


In early August, parents of more than 46,000 children received letters from the Missouri Department of Social Services informing them about new monthly premiums for their children’s MC+ healthcare coverage.

Starting in September 2005, families with income above 150 percent of the poverty level (above $24,135 for a family of three) will have to pay monthly premiums ranging from $12 to $257 per month (covering all enrolled children in the family). The premiums will be based on family size and income. Missouri Department of Social Services’ Division of Medical Services mailed invoices on September 1, 2005 to families affected by the premium change.


The premium schedule and other information about MC+ for children can be found on the new MC+ Web site at You can order print materials about the change online from the Web site.


Many people probably agree that monthly premiums are not a bad thing and that the premium amounts are reasonable. The real problem arises when families are late with the monthly premium payment. When this happens, the child loses MC+ health care coverage and parents can’t reapply for 6 months! There is a great way to be sure monthly payments get in on time. Families can have the payment taken out of their checking account automatically each month. This may be difficult for some families, but it is the easiest and safest way to assure that the payment is received on time.


Three general messages must be conveyed to families to help them maintain healthcare coverage under Medicaid/MC+.

  1. All address and phone number changes should be reported to the family’s FSD caseworker. It is critical that FSD know how to reach families by mail and/or phone.
  2. All mail from FSD must be opened and responded to right away. The timeframe for a response is often only 10 days from the date the letter was sent from FSD.
  3. Letters from FSD may be difficult to understand. Families should call their caseworker immediately if they need help. The phone number will be on the letter.

This is critical because FSD caseworkers are now required by Missouri law to conduct annual reviews of all Medicaid/MC+ recipients. Families who do not respond in a timely manner may lose coverage.


To find more detailed information about the cuts to Medicaid, see

Agencies and groups that serve families can play a key role in ensuring that information reaches families. Information can be provided to families at workshops, in mailings, through the media, and in one-on-one meetings. Making sure that eligible children have healthcare coverage is everyone’s job.



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Last Updated 05/05/2009