Missouri Battlelines Drawn Over Medicaid Expansion

Published January 16, 2013

A partisan battle is shaping up in Missouri over the Medicaid expansion mandated by President Obama’s health care law.

Under the U.S. Supreme Court’s June ruling, states may decide whether they will accept federal funds to allow families and individuals making up to 138 percent of the federal poverty level to receive Medicaid. Democratic Gov. Jay Nixon recently embarked on a statewide tour to drum up support for the expansion.

“My consistent position on expanding Medicaid has been to carefully study the options and then determine what is the best fit for Missouri,” Nixon said in a statement.

But Missouri Republicans, who now have supermajorities in both the state House and Senate, said following the general election they opposed the expansion.

“The basic conclusion is the state cannot afford it,” said House Speaker Tim Jones, R-Eureka.

Free Money for Just $1.6 Billion

Under the Medicaid expansion, the federal government would pay all the costs of the expansion for the first three years, but states would owe 5 percent beginning in 2017. That would gradually increase to 10 percent in 2020.

The Kaiser Family Foundation estimates the expansion would cause Missouri’s Medicaid rolls to increase by 383,000 by the year 2022. That would bring $17.8 billion in federal Medicaid money into the Show Me State the first nine years of the program, and Missouri would pick up $1.6 billion of the tab.

U.S. Sen. Claire McCaskill, a Democrat, argues Missouri would be foolish not to expand Medicaid.

“I just think it’s dumb to turn down this kind of resource that Missourians are paying for,” she told the Associated Press.

Medical Groups Eager

State medical groups, which stand to gain from the influx of funds, agree with McCaskill. The Missouri Hospital Association and Missouri Primary Care Association formed the Coalition for Healthy Economic Growth in an effort to convince lawmakers to expand Medicaid.

But State Sen. Rob Schaaf, R-St.Joseph, said he can’t see the General Assembly passing such legislation for a simple reason: the money’s not there.

“It’s kind of like if you were to buy a house or a new car and there were no payments for three years,” Schaaf told the St. Joseph News-Press, “but after that you would have to pay for it forever. You might not want to do that.”

Johnny Kampis ([email protected]) writes for Missouri Watchdog.