Proponents of expanding Medicaid in Missouri just landed an influential — and unlikely — new ally.
Republican and former U.S. Sen. Kit Bond has been hired as a lobbyist by the Missouri Chamber of Commerce and Industry. His goal will be to persuade a General Assembly skeptical of all things Obamacare to go along with one of the law’s central tenets — adding 300,000 uninsured Missourians to the public health insurance program for the poor.
“It’s Republicans who are uncertain on this issue, and there are few Republicans in Missouri who have more respect and credibility than Kit Bond,” said Dan Mehan, the Missouri chamber’s president.
Bond served two terms as Missouri’s governor before being elected to the U.S. Senate in 1985. He went on to serve four terms in Washington.
He’s also been an outspoken critic of the federal health insurance law. During a 2010 interview with the conservative magazine Newsmax, Bond said thefinancial burden on state budgets of expanding Medicaid
would be “horrific.”
Last November, in aninterview with The Joplin Globe
, he referred to the law as “a pile of manure.”
Bond could not be reached for comment Thursday, but Mehan said Medicaid expansion is no longer about support or opposition to the federal law. The chamber was an early and outspoken advocate for expanding Medicaid in Missouri after the Affordable Care Act took effect.
“We opposed Obamacare, and every day it seems like a worse and worse idea,” he said. “But it is the law, it’s been upheld by the courts and we don’t see it changing anytime soon. We should take the opportunity to get an enormous amount of investment back into our state and, while we’re at it, improve Medicaid for everyone.”
Since officially taking the job Jan. 16, Bond has wasted no time reaching out to his fellow Republicans.
“He’s already stopped by my office,” said Sen. Ryan Silvey, a Kansas City Republican opposed to expansion who previously worked in Bond’s Senate office. “It is very interesting to be lobbied on any issue by someone you consider to be a mentor.”
States can initially receive 100 percent federal funding to expand Medicaid coverage to adults earning up to 138 percent of the poverty level — an annual income of about $32,500 for a family of four. The state’s share of the costs increase gradually to 10 percent by 2020.
Currently, adults in Missouri only qualify for Medicaid if they earn less than $4,500 annually for a family of four.
Proponents of the idea point to numerous studies arguing that increasing Medicaid funding would inject billions into the state’s economy and create thousands of new jobs.
But Republicans have expressed concerns about the long-term costs both to the federal and state governments. Lawmakers should focus on ways to make the Medicaid program better, they contend, not necessarily larger.
While the Missouri House last year pushed a plan that would have implemented reforms to Medicaid in exchange for expansion, the Senate balked at the idea.
Once the state has to start paying its 10 percent, we’re looking at spending $200 million that we don’t have,” Silvey said. “If we can craft a plan to offset that $200 million, I’d be happy to entertain it. But I haven’t seen that proposal.”
Any proposals to reform Medicaid will require federal waivers, Mehan said, and the federal government is unlikely to approve a waiver without expansion.
“The longer we wait, the less likely we’ll be able to truly improve Medicaid,” Mehan said. “The window of opportunity is closing.”
Bond is widely admired among Missouri politicos, Silvey said. But admiration alone won’t be enough to sway legislators.
“At the end of the day,” he said, “we have to make the numbers add up.”