Nixon calls for Medicaid expansion

Dennis Rich

April 9, 2014

Missouri Gov. Jay Nixon used a Wednesday stop at Bothwell Regional Health Center to call for the state to join Medicaid expansion called for under the Affordable Care Act.

“Standing still is moving backwards,” Nixon told a crowd of hospital staff, area health care professionals and members of the public, a little more than a year after a series of similar stops in 2013 that yielded no results from the Missouri General Assembly.

Under ACA, states may expand Medicaid coverage — administered in Missouri by MoHealthNet — to include people making up to 138 percent of the federal poverty level, equal to about $31,800 a year for a family of four or $15,400 a year for a single person. Under the expansion, the federal government would pay 100 percent of costs through 2016.

In 2017, the state would be required to provide 5 percent in matching funds, with the state’s share increasing through 2020 when it would top out at 10 percent.

In Missouri, Medicaid currently covers people making up to 19 percent of the poverty level, or about $4,500 for a family of four.

As the health care reform law was drafted, Medicaid expansion was supposed to compensate for reduced Medicare payments to hospitals and health care providers — a move that was originally anticipated to cost BRHC about $22 million, but has since grown to some $35 million.

Nixon said the legislature’s failure to expand Medicaid last year has had tangible effect on the state’s economy, the working poor and hospitals.

“Since Jan. 1, Missouri taxpayers have spent more than $530 million and counting to provide health care in other states — and where our tax dollars have gone, jobs have followed,” Nixon said. “By denying Missourians any of the benefits but sticking them with the entire bill, the General Assembly is delivering Missouri families a one-two punch.”

The failure to expand Medicaid has also left about 300,000 Missourians without access to coverage, even though state taxpayers contribute $5.47 million a day in federal tax revenues that are now going to support expansion in other states, Nixon said.

He also cited a March report from the Missouri Chamber of Commerce and the Missouri Hospital Association that found the failure to expand Medicaid has led to the loss of some 3,000 health care jobs across the state, a point echoed by BRHC CEO John Dawes.

“Because the legislature has failed to expand Medicaid, these costs will continue to rise, meaning we may be forced to consider cuts in services,” Dawes said, noting the hospital has cut 50 full time equivalent positions since the beginning of the year. “As one of the largest employers in Pettis County, we need Medicaid expansion so we can continue to provide care for the community and jobs for our local economy.”

Nixon reported progress in conversations with Missouri lawmakers and encouraged people to contact their representatives and encourage them to support expansion.

“With a little more than a month left in the legislative session, I urge the General Assembly to take action necessary to prevent further damage to our economy and bring Missourians’ tax dollars home,” Nixon said.