The health and well-being of tens of thousands of Missouri’s most vulnerable citizens were jeopardized this week by five people in order for those people to keep up appearances.
This truth is alarming in itself, but it’s even more alarming that this was a fairly unsurprising and ordinary occurrence. As we have come to be familiar with, this is simply the way Missouri’s state legislators — people we have elected to serve and protect us — behave.
A major portion of the Affordable Care Act — first derided as and then commonly known as “Obamacare” — gives money to states to expand their Medicaid programs to cover citizens with incomes up to 138 percent of the poverty level. For the first three years of the expansions, the federal government will cover all of the increased cost; after that, the states will have to pay a little more, but never more than 10 percent of the expansion.
Of course, the ACA, a sprawling, convoluted work of legislation, was immediately distorted into a very simple idea — the takeover of your personal health by “big government” — and associated with a single man, President Barack Obama. As such, it became a partisan dividing line, with Democrats supposedly having to support all of it and Republicans having to reject all of it, regardless of the potential benefits or risks of any of its provisions.
Therefore, when the five Republicans of the Missouri House Committee on Government Oversight and Accountability voted against the committee’s two Democrats and killed legislation to expand state Medicaid with federal funding from the ACA, hardly an eyebrow was raised. Partisanship and rigid idealism stood, and aid for Missouri’s poorest (as well as an estimated 24,000 new jobs for Missourians) fell.
Assuming states would take the Medicaid expansion and cut the number of uninsured citizens, the ACA reduces federal funding for hospitals to recoup emergency room costs from uninsured patients. University Hospital, for example, will lose $5 or $6 million. Thanks to Republican intransigence, not only will Missouri miss out on essentially free money from the government, it will be losing money.
To rectify the state’s Medicaid budget, Rep. Jay Barnes, R-Jefferson City, the committee’s chairman, introduced a “market-based” reform plan Tuesday, which would “trim the rolls” of the state Medicaid program and end medical insurance for up to 44,000 low-income Missouri children (the plan would also add some adults and provide private insurance for Medicaid recipients above the poverty line).
“Trimming the rolls” is easy to write and glides off the tongue, but the sad truth — tens of thousands of poor children around the state being deprived of health care, to say nothing of the tens of thousands of additional low-income citizens who will remain uninsured due to the failure of the Medicaid expansion bill — is much harder to accept. It’s even harder to accept when we see the obvious benefits the federally-funded expansion would have brought, and how it was killed due to nothing more than intransigence on the part of Republican state legislators.
Semantics and posturing aside, it is clear to us that this was not a vote to help Missourians — it was a vote on Obamacare, and on the image of “big socialist government” that has come to be the imagined enemy of many, if not most, Republican lawmakers both in Jefferson City and in Washington. The five Republicans on the committee hurt tens of thousands of Missourians just to be anti-Obama and present an image of hardline fiscal conservatism, as they have for the past several years.
We are fed up with everything in the General Assembly having to be a political move. People are hurting and sick, people are dying needlessly, and state legislators continue their posturing for political gain and ideological rigidity. Of course, that is what politicians are expected to do, but we are sure that it is possible to be fair, analytical and objective in the Statehouse.
Gov. Jay Nixon, a (mostly) fiscally conservative Democrat, originally opposed the ACA as a needless increase in federal spending, but decided the benefits of the Medicaid expansion outweighed the costs. He came to the MU campus on Feb. 7 and spoke in favor of the expansion (unless the federal government stopped paying for it, a condition we understand and applaud). That is progress. That demonstrates a willingness to consider all options and make a decision without regard for party lines or political “enemies.” Unfortunately, it appears as though state Republicans, along with many state Democrats, are far from embracing that kind of thinking.
This week’s events were simply untenable. When legislators seemingly face a choice of either helping our poorest neighbors and scoring one for the Democrats, or denying them basic health care and scoring one for the Republicans, and are completely willing to choose the latter, it has gone too far. We allow that it’s important to have principles — government can go overboard and spend too much, and it’s necessary to keep that in check. But refusing a plan that provides maximum benefit at minimum cost to the state simply out of opposition to Barack Obama is senseless and despicable. Principles got in the way of progress this week in Jefferson City, and this needs to change.