By Johnny Kampis | Missouri Watchdog
ST. LOUIS — A battle is shaping up next year on the Medicaid expansion of the health care act, pitting state Democrats against Republicans.
Democratic Gov. Jay Nixon embarked on a statewide tour Thursday to publicly support increasing the number of Missouri residents who can join the Medicaid rolls.
The U.S. Supreme Court ruling in June on the Patient Protection and Affordable Care Act allows states to decide whether they will accept federal funds to allow those families and individuals making up to 138 percent of the federal poverty level to receive Medicaid.
“My consistent position on expanding Medicaid has been to carefully study the options and then determine what is the best fit for Missouri,” Nixon said in a statement. “That is why the budget I plan to submit to the legislature for fiscal year 2014 will include federal funding to provide health care for an estimated 300,000 Missourians – men, women and children — who currently have no health insurance. It’s the smart thing to do, and it’s the right thing to do.”
Nixon’s position is not beloved by many state Republicans, who now have a supermajority in both the state House and Senate, giving the GOP more power over the governor and likely killing his Medicaid goals.
Several Republicans said following the general election that they opposed the expansion.
“The basic conclusion is the state cannot afford it,” said House Speaker Tim Jones, R-Eureka.
The federal government would pay all the costs of the expansion the first three years, but states would owe 5 percent beginning in 2017. That would gradually increase to 10 percent in 2020.
The Kaiser Family Foundation released a report this week estimating that Missouri’s Medicaid rolls would increase by 383,000 people by 2022 if the expansion is implemented. That would bring $17.8 billion in federal Medicaid money into the Show Me State the first nine years of the program, and Missouri would pick up $1.6 billion of the tab
State Sen. Rob Schaaf, R-St.Joseph, said he can’t see the General Assembly passing such legislation because the money’s not there.
“It’s kind of like if you were to buy a house or a new car and there were no payments for three years,” he told the St. Joseph News-Press, “but after that you would have to pay for it forever. You might not want to do that.”\
“I’m a little disappointed that the governor didn’t come and work with the Legislature prior to taking his position,” Schaaf said.
State medical groups, meanwhile, tout that a Medicaid expansion could add thousands of jobs across Missouri.
The Missouri Hospital Association and Missouri Primary Care Association formed the Coalition for Healthy Economic Growth on Wednesday in an effort to convince lawmakers to expand Medicaid.
That group and the Missouri Foundation for Health issued a report that said the increased spending would likely increase employment in nursing homes, hospitals and other health-care facilities by 24,000 during the first year of the expansion.
The study also said the boost in jobs and economic activity would generate an additional $856 million in state and local taxes.
“This effort has the potential to have the greatest statewide economic impact in terms of job creation, income growth and revenue growth of any initiative ever considered by our elected officials in the past decade,” said Joseph Pierle, CEO of the primary care association and chairman of the coalition.
The report said hospitals could lose federal funding if the state chooses not to participate because the health-care law reduces payments for treating uninsured patients under the assumption that more of them will have Medicaid coverage.
U.S. Sen. Claire McCaskill, a Democrat, said this week that if Missouri doesn’t expand Medicaid then some of its taxes would go to pay the federal share in other states.
“I just think it’s dumb to turn down this kind of resource that Missourians are paying for,” she said.
— Edited by Kelly Carson, [email protected]