Missouri receives first portion of stimulus

The federal stimulus funds are intended to match state expenditures for Medicaid in 2008.

By Andrew Denney

Published Feb. 27, 2009

Missouri received its first batch of federal stimulus funds on Thursday, and the governor has preempted contention from Republicans in the legislature by creating separate accounts to segregate different types of federal money.

In a news release issued Thursday, Gov. Jay Nixon announced the state has received more than $223 million of what is expected to be more than $4 billion paid to Missouri to prevent cutbacks to state-funded services, such as Medicaid. The funds distributed to the state on Thursday are matching funds the federal government provides to compliment state expenditures for Medicaid. They were paid retroactively from last year's expenditures, but at an enhanced rate set by the American Recovery and Reinvestment Act of 2009 signed into law last week by President Barack Obama.

Much to the satisfaction of Republican leadership in the General Assembly, Nixon said the funds would be held in one of two separate accounts he created in the State Treasury to receive stimulus dollars.

A plan to form the separate accounts had previously been proposed in legislation by Sen. Gary Nodler, R-Joplin, which will likely reach a vote on the Senate floor this week, and still requires the governor's signature.

"Creating and using these funds are the best way to protect Missouri taxpayers because it makes the new federal funding separate, only lets us spend what we have, and lets taxpayers know exactly what projects and programs we invest in with this one-time funding," Nodler said in a news release. "We will continue to work to get the bill to the governor's desk ready for his signature as quickly as possible."

Nixon spokesman Scott Holste said the federal funds would still have to be submitted for approval from the legislature before they are committed to any certain expenditure.

In his budget proposal submitted in January, Nixon included $809 million of expected federal funds. The governor also proposed $360.8 million in additional expenditures to maintain the current Medicaid service levels, as well as $37 million more in state appropriations to expand Medicare coverage to 62,000 additional recipients.

Sen. Joan Bray, D-St. Louis, who is co-sponsoring Nodler's bill, has also proposed several pieces of legislation that would also expand health care coverage. She said increasing health care accessibility should be a priority for the state.

"I think it's a real burden on the state to have uninsured people," Bray said. Bray has proposed legislation that increases eligibility for the state's Medicaid program and would also form a commission to study the possible implementation of a universal health care program in the state. That measure was passed by the Senate Progress and Development Committee, of which three of its five members are Democrats, and is on the calendar for a third reading on the Senate floor.

Senate Majority Caucus spokeswoman Farrah Fite said Senate Republicans want to find ways to provide Missouri's uninsured with access to health care without expanding state Medicaid coverage. She said there are concerns that the state would not be able to sustain a larger Medicaid program.

"If we are looking to Medicaid as the answer, there are going to be a lot of people in and out of care," Fite said.

One plan for taking care of the state's uninsured that state lawmakers have considered in past years, Fite said, was to fund preventative care programs with money that the state normally uses to reimburse hospitals for unpaid emergency room bills. She said working with hospitals and private insurance providers would be the best way to form a plan to provide health care to the uninsured.

The issue of health care affordability brought hundreds of health care advocates and people with disabilities together for a rally in the Capitol on Wednesday.

Bob Pund, a legislative advocate for disability issues, who was at the rally, said the group came to Jefferson City to promote the reinstatement of cuts to Medicaid that the state approved in 2005, which Nixon had promised to do on the campaign trail before he was elected. But, he said he knew "fiscal realities" and Republican resistance in the legislature would prevent a full reimplementation of the beneficiaries that lost eligibility to the program in 2005.

He said, in a sagging economy, paying for health care would become more challenging for Missourians.

"It's going to hit the poorest people, people that might not be the healthiest, first," Pund said.