Clancy’s Cafe and Pub is going smoke-free. Owner Jamie Walsh said it’s time.

“Honestly, I just think that times are changing,” he said.

The popular spot in Blue Springs has been there for 17 years.

“I’ve been breathing it long enough, and I think other people have, too,” he said.

The change takes effect Thursday.

There was a brief wave of metro cities banning smoking in dining establishments a few years ago. Independence and other cities signed on. Blue Springs didn’t.

But Walsh said it was getting old to hear some customers complaining. The smoke from the bar inevitably drifts over to the restaurant side.

“There’s just so many families that can’t bring their kids in,” he said.

Backlash? Maybe some, Walsh said. Most smokers, however, are considerate and understand the need to take it outside, he said.

New in town

Bill Haney spent many years in medical sales. Then there was a merger, and then came the cuts.

“So I went out to look for a job,” he said.

The result is a new company in Blue Springs, Express Employment Professionals. Haney bought the territory that includes all of Eastern Jackson County. The company has 650 franchises in the U.S. and elsewhere.

Express Employment helps place people in very short-term to long-term jobs, and Haney said it’s methodical in screening and other tasks. He stressed that the company is the only of its kind that is ISO 9000 certified.

Like any new business owner, he’s out drumming up business, as he was the other day at the Eastern Jackson County Business Expo.

“I go out and knock on doors,” he said, “so I have to go out and find people looking for employees.”

Two jobs, no help

Advocates of expanding Medicaid in Missouri have had a strong ally for the last couple of years – many of the state’s most powerful business leaders.

It’s a matter of job retention and growth, stability for hospitals – which are major economic drivers in their communities – and helping people and the companies they work for, advocates argue.

“And healthy employees are happier and more productive, period,” said Brendan Cossette, director of legislative affairs for the Missouri Chamber of Commerce and Industry, during a statewide conference call the other day.

Expansion has run into a brick wall in the General Assembly, and Cossette and others said part of the problem could be the perception that most of those who would gain coverage are not working.

“And that’s not the case,” he said.

FamiliesUSA ran the numbers and came up with 350,000 Missourians who would gain health coverage if the state expanded Medicaid along the lines Washington wants. That’s a little higher than the number Gov. Jay Nixon and others have talked about.

Of those, 200,000 have jobs – often two or three jobs.

“Most of these folks work, and they work hard,” said Andrea Routh, executive director of the Missouri Health Advocacy Alliance.

How does that break down? About 34,000 of those, for example, are cooks, waitresses and fast-food workers. Another 24,000 work in sales, and 22,000 are housekeepers, landscapers or janitors. Then there’s health care itself – 12,000 people in fields such as nursing aides, home-health aides and dental assistants.

“But the point is these are working people, sometimes working two or three jobs ...” Routh said.

Of those 350,000, about 40 percent don’t work – half because they are disabled or students or non-working spouses. The rest are unemployed.

Gov. Nixon wants to expand the program, and the Missouri chamber – like the chambers of commerce in Independence, Blue Springs and the other 50 largest cities in the state – have endorsed the move.

Cossette put it this way. Many of the Missouri chamber’s members are not thrilled with President Obama’s Affordable Care Act.

“But they are pragmatic,” he said.

Under the ACA, Washington is strongly encouraging – and largely paying for – states to expand Medicaid coverage to cover the last major gap in uninsured Americans. So far, about half of the states have signed on.

Missouri hasn’t signed on, and Nixon has hammered away at the idea that Missourians’ federal taxes dollars are going to other states while this state misses out on $2 billion a year.

“That’s $5 million a day,” Cossette said.

Cossette said hospitals, particularly in rural areas, are being squeezed. The uninsured often show up in the ER, where hospitals have to treat them, and those hospitals get some federal money to offset those costs – money that’s scheduled to go away under Obamacare under the idea that Medicaid would instead pick up those costs. Now, Cossette said, hospitals in Missouri have cut jobs and put off expansion projects.

State Rep. Noel Torpey, R-Independence, has a bill to restructure and expand Medicaid and says the votes are there in the House for passage. But House leaders won’t allow a vote, and a handful of senators have promised to filibuster if the issue comes up in the Senate.

“I think there are a lot of Republican legislators who are ready to vote for this, but the problem is we’ve got to get a vote,” Routh said.

Nixon and others have characterized the opposition as an attempt to stymie Obamacare at every turn and, to some extent, simply to spite the president. Cossette said the state’s business leaders are more practical.

“These folks realize it doesn’t do any good to put our heads in the sand and hope the Affordable Care Act goes away,” Cossette said.

The advocates also underlined some fairness issues.

Cossette points out that a family of four with an income of up to $89,000 a year can go to the government’s health exchange to buy insurance and, under Obamacare, qualify for a subsidy. But under Missouri’s Medicaid program, a family of four with an income of $5,000 gets zero.

And there is the overall stinginess of Missouri’s current Medicaid program. Adults with no dependent children cannot qualify at all. A family of three has to have an income of $4,750 or less to qualify.

“Most of us can’t even imagine living on a salary of $4,750 a year,” Routh said.

Torpey’s bill has a requirement that Medicaid recipients be working or looking for work – a provision Routh suggested might run afoul of federal law, though she said the federal government has shown an eagerness to work with the states on this issue.

“All the concerns that have been raised by conservative legislators,” she said, “have been addressed by conservative legislators.”

Jeff Fox is The Examiner’s business reporter and editor. Reach him at 816-350-6313 or He’s on Twitter @FoxEJC.