Missouri Democrats say rural hospitals need expanded Medicaid

The leader 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, the CEO of Pemiscot Memorial Hospital in Hayti, stood alongside Rep. Jake Hummel, the House minority leader, 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 opposed the idea — Noble said his hospital, in southeast Missouri, would lose around $1 million a year in federal reimbursements for treating uninsured patients.

Those payments are being cut under the Affordable Care Act, often referred to as Obamacare, on the assumption that uninsured patients ultimately would be covered by an expanded Medicaid program.

Noble said losing that money wouldn’t mean the hospital would close immediately, 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 statewide. He pointed to a recent study that estimated expanded Medicaid would create 24,000 jobs in the first year and add 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 alternatives to expanding Medicaid.

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

“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.”

Barnes said Hummel’s bill stands little chance of approval by a committee, let alone the full House.

Last week, Rep. Rick Stream, a Kirkwood Republican and chairman of the House Budget Committee, filed bills that did not include the $900 million in federal money to expand Medicaid requested by Gov. Jay Nixon, a Democrat.