Missouri Democrats roll out Medicaid expansion bill

JEFFERSON CITY – The CEO of a rural Missouri hospital warned lawmakers Monday that failure to expand eligibility for Medicaid could put institutions like his at risk of failure.

Kerry Noble, CEO of Pemiscot Memorial Hospital in Hayti, Mo., stood alongside House Minority Leader Jake Hummel to unveil legislation that would expand Missouri’s Medicaid eligibility requirements to 138 percent of the federal poverty level, as called for by the federal health care law.

If Medicaid is not expanded – and Republican legislative leaders have been less than enthusiastic about the idea – Noble said his hospital would lose around $1 million a year in federal payments to reimburse hospitals for treating uninsured patients.

Those payments are being cut under the Affordable Care Act, often referred to as Obamacare, on the assumption that those without insurance would ultimately be covered by an expanded Medicaid program.

Losing that money wouldn't meant the hospital would close immediately, Noble said, but it would cause the level of care to “deteriorate over time, which would put the facility at risk.”

“Pemiscot Memorial has 550 employees, a $20 million payroll and is the second largest employer in the county,” Noble said. “If we lose that hospital, not only would it be difficult for patients to access medical care, it would be traumatic to the Bootheel region economically.”

Hummel, a St. Louis Democrat who is sponsoring the legislation to expand Medicaid, said the economic impact of doing nothing would be felt around the state. He pointed to a recent study that estimated 24,000 new jobs would be created in the first year of expansion, in addition to adding 260,000 people to the public health insurance program for the poor.

“We can accept billions of dollars in new economic activity into the state or let billions of dollars in investment walk away,” Hummel said. “We can infuse our rural hospitals with additional resources or we can let them go out of business.”

House Speaker Tim Jones, a Eureka Republican, has assigned three GOP lawmakers to work on a possible alternative to simply expanding Medicaid.

Leading that effort is Rep. Jay Barnes, a Jefferson City Republican who said he plans to unveil his legislation next week. He declined to lay out any specifics when asked on Monday.

“We are not going to expand Medicaid as envisioned by Obamacare,” Barnes said. “The bill I’m filing next week will make Missouri’s Medicaid system the most market-based system in the nation. So stay tuned.”

As for Hummel’s bill, Barnes said it stands little chance of even being approved by a committee, let alone the full House.

Last week, House Budget Chairman Rick Stream, a Kirkwood Republican, filed budget bills that did not include $900 million in federal money to expand Medicaid requested by Gov. Jay Nixon.