Local state legislators are speaking generally in favor of changing and expanding the state’s Medicaid program – adding health coverage for hundreds of thousands of Missourians – but question whether it will pass this year.

“I think it’s inevitable. I think we will reform and expand Medicaid, but will it happen this year? I don’t know,” state Sen. Will Kraus, R-Lee’s Summit, said at last Friday’s Eggs & Issues breakfast put on by the Independence Chamber of Commerce and the Independence Council for Economic Development.

Chambers of commerce in the state’s larger cities – including Independence, Blue Springs and Lee’s Summit – have endorsed expanding Medicaid, or MO HealthNet, as a matter of retaining jobs at hospitals and elsewhere. The Independence chamber has again put it near the top of its legislative priority list.

“It’s good for business, and it’s good for our citizens, so I’ll keep pushing for that,” said Sen. Paul LeVota, D-Independence.

Last year LeVota sponsored a bill to expand Medicaid along the lines that the federal government is asking for. Washington would pick up the full cost of expansion for several years, and then scale back to 90 percent. LeVota said with cost savings legislators have looked at, state taxpayers would pay nothing extra for 10 years. For 2014 alone, he said, the state is missing out on $900 million.

“This is common sense that we would draw down our federal dollars,” LeVota said.

“I think it would be fiscally irresponsible for us not to do something,” said Rep. Noel Torpey, R-Independence, who led one House committee and was on another that looked deeply into the issue last summer and fall when legislators were out of session.

Gov. Jay Nixon has made Medicaid expansion a high priority, but the General Assembly did not pass such a bill last year. Republicans, who control both houses of the legislature, say the program needs to be reformed before there’s any consideration of expanding it. LeVota indicated he now favors that reform-first approach.

Still, Torpey said a mom working two jobs ought to have health coverage.

“And I think with the right reforms we can do that,” he said.

Even with that, local legislators said, it’s a tough sell in an election year. Expanding Medicaid – half of the states have done it, half haven’t – comes with incentives Washington is offering under the Affordable Care Act, or ObamaCare. Legislators said voting to expand the program can be portrayed by political adversaries as supporting ObamaCare.

“That’s not true, but it’s the political reality,” Torpey said.

MO HealthNet covers about 800,000 people, generally children and pregnant women. That’s about one in seven Missourians. It pays for about half of the births in the state. Washington wants to raise the income limits so some working adults without children also would be eligible. That would add close to 300,000 people.

The General Assembly convenes Wednesday and adjourns in mid-May. Torpey said the chances of reform or expansion will greatly depend on the details of whatever bill emerges.

“We would save millions of dollars if done correctly. ... We’re not going to pass something that’s not fiscally responsible,” he said.