The two men running for the Missouri Senate in the 34th District are both doctors. Both cited experiences they had as physicians as motivation to run.
But they come down on very different sides of a medically focused debate in Missouri: whether the state should expand Medicaid as envisioned in the federal Affordable Care Act.
Rob Schaaf, the incumbent in the 34th District, which includes Platte County, said that expanding Medicaid in Missouri would be too expensive for the state.
“The state will not be able to afford the cost as it ramps up over the next five years,” he said.
Schaaf, who said he initially ran for the legislature because of frustration with getting his patients the care they needed, is concerned that Medicaid expansion would end up taking money away from the education budget.
“Nor does it fix the underlying problems in our health system caused by lack of competition,” he added.
Robert Stuber said that expanding Medicaid is one of his top priorities. Doing so, he said, would create more jobs and salaries, which would increase state tax revenue.
Refusing to expand Medicaid, he said, puts rural health care systems at risk for a hefty financial burden as federal subsidies to rural hospitals decrease.
Stuber, who has worked for the last 12 years at a clinic that serves the impoverished, also talked about his experience dealing with underserved populations.
“Without Medicaid expansion, the very people the Affordable Care Act was intended to help are excluded in the state of Missouri,” he said.
One reason Stuber decided to run has a medical focus. Missouri is the only state that doesn’t have a central narcotics registry.
Schaaf filibustered legislation to set up a database in 2012. Stuber said this was the tipping point when he was deciding whether to seek public office.
“It would have brought us up to speed with the other states,” he said, adding that the filibuster “was unbelievably irresponsible and arrogant.”
Schaaf said private medical information couldn’t be protected once it’s made available to more than 26,000 licensed health care providers, and there’s evidence that databases make it harder for patients in pain to get needed pain medicine.
“I have had legislators, physicians and patients contact me urging me not to allow Missouri to repeat the mistakes made in their states,” said Schaaf, adding that filibustered only after database advocates refused to put the matter to a vote of the people.
Both doctors agree on one current medical question: whether medical marijuana should be available to patients. They’re in favor.
Schaaf voted for the original bill requiring women to wait 72 hours after consultation to get abortions. He also voted to override Gov. Jay Nixon’s veto of the bill.
Stuber said the law is unfair to poor women, as the state has only one abortion clinic, and many people across the state already have to travel to get the procedure.
The candidates also disagree on tax cuts.
Schaaf voted for income tax cuts and for the override of the governor’s veto. He said the primary thing that draws business to a state is its tax climate.
“Keeping more dollars in the hands of taxpayers allows them to increase their standards of living, and that helps our economy,” he said.
Stuber said enacting more tax cuts doesn’t save the middle class or the poor, but only helps upper-income Missourians save money.
“It decreases revenue, and that makes for difficult budgetary decisions,” he said. “Who gets hurt when that happens? It’s usually the people who have no voice, and that’s usually the poor and middle class.”
Address: St. Joseph
Occupation: Physician, businessman
Education: Medical degree, St. Louis University; bachelor’s in mathematics, Missouri Western State College
Previous public experience: Missouri Senate, 2011-14; Missouri House, 2003-10
Address: St. Joseph
Education: Bachelor’s in physiology and medical degree, both from the University of Kansas
Previous public experience: None