Nixon calls for expansion of Medicaid in Missouri

JEFFERSON CITY | Gov. Jay Nixon is calling on lawmakers to expand the public health insurance program for the poor to include an estimated 300,000 additional Missourians.

The expansion of Medicaid is part of the federal health care law, known as the Affordable Care Act, and is designed to provide coverage to millions of low-income residents who can’t afford insurance.

Missouri Republicans, who hold super majorities in both legislative chambers, have steadfastly opposed the idea. But Nixon, a Democrat, said he’s come to the conclusion that the expansion is “the smart thing to do, and it is the right thing to do.”

“This is not the time to open the debate on that act or argue the merits of that act,” Nixon said Thursday morning. “Congress passed it, the president signed it and the Supreme Court upheld it. It is the law of the land.”

The federal government would pay the additional cost initially, with states picking up 5 percent beginning in 2017 and 10 percent by 2020. Nixon said his office estimates an additional 300,000 people would be eligible for coverage. Other estimates have ranged from 160,000 to 250,000 newly insured.

“If we do this correctly, we’ll improve the health and quality of life for hundreds of thousands of Missourians and transform the expensive and scattershot way we now provide care for people without health insurance,” Nixon said. “Providing health insurance for these folks is the right thing to do.”

In June, the U.S. Supreme Court ruled that states could refuse to expand their programs, and since then Missouri lawmakers have repeatedly balked at the idea. They argued that the additional costs down the road are prohibitive and could force lawmakers to make cuts to other programs, such as education.

“We already are in a position every year where we have to decide where to cut because of Medicaid growth,” said House Speaker Tim Jones, a Eureka Republican. “Even though the carrot being offered by the federal government is generous, long term the states will be on the hook for more and more money.”

Estimates about how much the expansion will eventually cost the state vary, and most fail to include potential savings that could occur. An often cited example is money the state pays for health care for disabled populations that would be covered under the expanded Medicaid limits.

A study released yesterday prepared by the University of Missouri and the Vienna, Va.-based health care consulting firm of Dobson DaVanzo and Associates estimatesd that a Missouri Medicaid expansion would cost the federal government $8.2 billion and the state $333 million between 2014 and 2020.

Nixon said he’s confident expanding Medicaid is fiscally sound, and he believes Republicans will eventually come on board.

If Missouri turns down the federal money it “will go to some other state. They’ll get the benefits, we’ll get the bill. That’s not smart, and that’s not right,” Nixon said.

Many hospitals around the state could take a massive financial hit if Medicaid isn’t expanded, Nixon said. This is due to a provision in the federal health care law that phases out payments to hospitals for treating the uninsured on the assumption that more people will have coverage either through private insurance or Medicaid.

The Missouri Hospital Association has warned that this situation could force many hospitals to close.

The governor will formally lay out his proposed budget during his State of the State address in January.

Read more here: http://midwestdemocracy.com/articles/gov-nixon-calls-expansion-medicaid-missouri/#storylink=cpy