Missouri Medicaid Battle Unlikely to Result in Expansion

Published March 14, 2013

Despite Missouri Democratic Governor Jay Nixon’s interest in expanding Medicaid under President Obama’s health care law, it appears Republicans in the state legislature have the votes and the will to block the expansion.

According to Republican Lt. Gov. Peter Kinder, the reelection of President Obama and Gov. Nixon in November did not create a mandate to expand the low-income assistance program pushed by Democrats in the state.

“[Gov. Nixon] did not seek a mandate on Obamacare. He didn’t even talk about it during the campaign,” Kinder said. “There can’t be a mandate if you did not lay a program before the people and say I want to be reelected on the basis of this program.”

Despite Nixon’s attempts to make the case for the expansion during his first State of the State address of his second term and in a subsequent tour of the state, Republicans have consistently touted their opposition to expansion, and Kinder believes there is no compromise opportunity at this time.

“The Medicaid expansion is unaffordable, it is unworkable, it would break the state’s bank fiscally, and we are not going to do it,” he said.

Money Now, Taxes Later

Nixon has cited numbers from the Missouri Hospital Association, which estimates more than 300,000 Missourians would be added to the state’s Medicaid rolls under the proposed expansion. His supporters have also touted a study by the Missouri Budget Project, a progressive think tank, which suggests an expansion of Medicaid would significantly reduce the number of uninsured people in the state.

Yet these arguments are likely to fall on deaf ears among the Republican-heavy Legislature, according to House Speaker Tim Jones (R-Eureka). During the opening session of the Missouri legislature in January, Jones reiterated he’s not interested in accepting federal money to grow Medicaid, knowing the state would ultimately bear the cost through increased taxes.

Jones points out the state would have to kick in at least $431 million to expand the program, and some of the $8.4 billion spent on Medicaid under Obama’s law would already come out of Missouri taxpayers’ pockets. If the new Medicaid program were fully phased in, Missouri would pay a 10 percent share beginning in 2020 – revenue the state would have to find somewhere, perhaps by raiding other state priorities.

“One of the top concerns we must address this session is protecting education funding from continued encroachment by the governor’s welfare-expansion funding demands,” Jones said.

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