Federal Government Extends Health Care Program for Uninsured Adults in St. Louis City and County

ST. LOUIS, September 28, 2013 — The State of Missouri has received a one-year extension of its successful “Gateway to Better Health” (Gateway) Pilot Program from the Centers for Medicare and Medicaid Services (CMS). Gateway provides primary, specialty and urgent care coverage to uninsured adults in St. Louis City and County, ages 19-64, through a network of community providers and is sponsored by the Missouri Department of Social Services in partnership with the St. Louis Regional Health Commission (RHC). Before the extension, the program was scheduled to expire on December 31, 2013.

The extension of the Pilot Program preserves $30 million in annual funding for important community health care in St. Louis’ urban core through December 31, 2014. These funds will assist in providing a bridge for safety net providers and over 22,500 uninsured patients to coverage options until Medicaid expands in Missouri.

“Today is a good day for the St. Louis region. We are grateful to receive an extension of the Gateway to Better Health Program from our Federal partners,” said Robert Fruend, Jr., Chief Executive Officer of the St. Louis Regional Health Commission. “We are deeply grateful to Senator Claire McCaskill and Senator Roy Blunt, Representative William Lacy Clay and Representative Ann Wagner, Governor Jay Nixon and his staff at the Department of Social Services, County Executive Charlie Dooley and Mayor Francis Slay for their strong support in ensuring that the health care safety net remains in place in the St. Louis region.”

Under the terms of the extension, Gateway will cover individuals up to 100% of the federal poverty level (FPL) beginning January 1, 2014. This is a change from the previous income limit of 133% FPL for primary care and specialty care services and up to 200% FPL for specialty care services. This change will mean that approximately 4,000 of the 23,500 individuals currently enrolled in the Gateway program will no longer be eligible for Gateway coverage on January 1, 2014. Community health centers, RHC staff, and its partners are working to transition those individuals to other coverage options that may be available to them, and will continue to enroll eligible individuals under 100% of poverty into the Gateway program in 2014.  For new Gateway eligibility information, please visit

The RHC will continue to coordinate, monitor and report on the Demonstration Project. In its first complete year of operation (July 1, 2012-June 30, 2013), Gateway provided health coverage to more than 28,000 otherwise uninsured St. Louis area residents during the year. Gateway has paid for nearly 47,000 primary care and dental visits; more than 150,000 medications to manage chronic conditions and diseases; and more than 28,000 specialty and diagnostic care visits. Gateway also prevented an estimated 50,000 to 70,000 unnecessary emergency department visits last year.

The funds provided by the Demonstration Project represent about 20 percent of the total budget for community health centers operating in St. Louis. With the approval of the Demonstration Project extension, the Commission will continue working with its partners to ensure Gateway members maintain access to quality primary and specialty care services in the St. Louis region. The Commission also will continue its efforts to support the expansion of Medicaid eligibility in Missouri up to 133% FPL as a long-term solution to increased access to quality healthcare services.

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