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Nixon pushes for Missouri Medicaid expansion under Affordable Care Act

The expansion would make 8,700 Boone County residents eligible for coverage.

Feb. 1, 2013

Gov. Jay Nixon announced plans to use federal funds to expand Medicaid coverage in Missouri during his State of the State address Monday.

Missouri would be able to expand its Medicaid roles under the Affordable Care Act, President Barack Obama’s health care reform legislation. Under the expansion proposal outlined in the act, the federal government would provide funding to states that want to expand Medicaid coverage to citizens who make up to 38 percent more than the federal poverty level beginning in 2014.

Approximately 300,000 Missouri residents would be eligible to enroll in the Medicaid program following the expansion. According to a 2012 study conducted by the MU School of Medicine, there are currently 8,700 uninsured individuals in Boone County who would qualify for Medicaid under the expansion.

The study found expanding Medicaid would add 24,008 jobs in Missouri in 2014. Of those, 2,422 would come to Boone County and other parts of central Missouri.

Nixon lauded the federally funded expansion as a means of strengthening the economy of the state.

“Strengthening Medicaid will strengthen our economy,” Nixon said in his speech. “Without question, it’s the smart thing to do.”

Nixon urged the Republican-controlled legislature to cease debating the ACA and instead consider the Medicaid decision economically.

“Friends, let’s put the politics of health care aside for just a moment and look at this as a business decision for the state of Missouri,” he said. “Here in Missouri, we must make the smart business decision, the right human decision and bring the tax dollars we send to Washington back to work here in Missouri.”

In a rebuttal to Nixon’s address, House Speaker Tim Jones said an expansion of Medicaid would be fiscally irresponsible for Missouri.

“Our commitment is to stay true to the will of the people who have consistently voted with large majorities against the economy-crippling provisions of Obamacare, to find ways to keep the size of government small and to steer our state away from the same kind of fiscal cliff our federal government cannot seem to avoid,” he said.

Jones said Republican leadership in the legislature will propose an overhaul of the Medicaid program “to repair a broken system.”

Sen. Kurt Schaefer, R-Columbia, also expressed concern that the Medicaid expansion may decrease funding to other programs.

“One thing I will not allow to happen is increased welfare spending at the detriment of public education,” he said in an interview with the Associated Press.

Grass Roots Organizing, a Mexico, Mo., based non-profit, supports the expansion. It recently lobbied the Columbia offices of Sen. Roy Blunt, R-Mo., and Sen. Claire McCaskill, D-Mo., urging the senators to close corporate tax loopholes, which could prevent cuts to Medicaid and other social programs.

Executive director Robin Acree said although Blunt and McCaskill generally have progressive voting records on social programs and tax issues, GRO felt they could do more.

“We thought they could go further in closing some of these corporate tax loopholes and ensure there's no cost trimming or cutbacks at all for programs like Social Security, Medicare and Medicaid,” she said.

Last June, the U.S. Supreme Court upheld the constitutionality of most parts of the ACA, but ruled the federal government could not withhold funding to states that refuse to expand Medicaid benefits. As a result, states can now choose whether to use the federal funds to expand the program.

Under the ACA, the federal government will cover 100 percent of new enrollees’ costs starting in 2014. Beginning in 2017, Missouri will be responsible for 5 percent of those costs. Missouri will continue to cover larger percentages of the Medicaid costs until 2020 and years after, when it will pay for 10 percent of the expenses and the federal government will pay for 90 percent. Nixon said the program’s first three years will bring in $5.7 billion.

Nixon said he would include a twilight provision in the expansion, meaning if the federal government cut off its funding, Missouri would immediately end the expansion.

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