As a leader in the health care field in Kansas City, I am often surprised, but rarely amazed. You see, health care is a great profession, which serves a vital function of assisting people when they are physically or mentally in need. When working with human beings, funny behavior and surprises are common. But rarely, are they amazing.
I believe the same principle holds true for our state legislature and its members. After all, they are people, and so I have been surprised by their behavior and decisions but not often amazed. Until recently.
I was attending a legislator forum in the Northland. Several legislators were present, and various topics were discussed. The topic that consumed the most time and discussion was roads and a proposed increase in the gas tax. As you might recall, in August 2014, Missouri voters rejected a ballot initiative to increase the sales tax for roads. So, now the legislature is trying to develop a budget solution for Missouri’s Department of Transportation, or MODOT.
One idea to shore up the MODOT budget is an increase in the gas tax. Sen. Doug Libla of Poplar Bluff is proposing the 2+2+2 solution, which is a 2 cent gas tax increase for the next three years. After three years, the Missouri gas tax would increase as indexed to inflation. I’m not opposed to Sen. Libla’s proposal or the need to keep our roads maintained properly. But my surprise came from the arguments being made in favor of the 2+2+2 proposal.
As the legislators at the forum put it, we need to maintain the MODOT state budget in order to draw down federal matching dollars (match rate is 4-1 federal versus state), and we don’t want to lose tax dollars to other states and thus help build roads in other states. In fact, one legislator clearly stated that the legislature would not adjourn without having sufficient funds for the MODOT budget to secure the federal match.
Whoa! Here’s my surprise, now turning to amazement.
These are the exact same arguments made in the past and still made currently to support the expansion of Medicaid in Missouri. The expansion of Medicaid would add a federal match at a 9-1 rate (9 federal dollars for every dollar from the state) for four more years and continue the current match on new enrollees after four years at 3 to 1.
Also, the argument goes, we don’t want Missouri tax dollars going to other states to fund Medicaid expansion for their citizens. But that, of course, is what’s happening right now. At this particular legislator forum, there was no mention of Medicaid or saving Missouri tax dollars relative to Medicaid.
I was left with the conclusion that state tax revenue for roads is a greater priority than health care coverage for the low-income and poor citizens of Missouri.
That’s a value, or choice, reflected in the state budget and in the legislator arguments made in favor of shoring up the MODOT budget. It’s amazing to me that the health of the citizens of Missouri does not even warrant an open debate on Medicaid expansion — forget passing a bill, let’s at least just have a debate. But the health of our roads does. I’m amazed!
Tom Petrizzo of Kansas City serves as CEO of Tri-County Mental Health Services, a nonprofit behavioral health provider serving the Northland.