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Examiner
  • Governor presses Medicaid proposal

  • Missouri Gov. Jay Nixon stopped in Blue Springs on Thursday to again press his case for expanding the Medicaid program, and he picked up another endorsement.



    The Blue Springs Chamber of Commerce has joined the chambers in the other larger cities in the state in backing the idea.

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  • Missouri Gov. Jay Nixon stopped in Blue Springs on Thursday to again press his case for expanding the Medicaid program, and he picked up another endorsement.
    The Blue Springs Chamber of Commerce has joined the chambers in the other larger cities in the state in backing the idea.
    “Strengthening Medicaid will be a big win for our economy,” Nixon said during a visit to St. Mary’s Medical Center.
    Republicans, who control both houses of the Missouri General Assembly, have not taken up the governor’s plan, but he pointed to a meeting with House Republicans this week that he said went well and said he sees a chance of progress.
    About 900,000 people are on Medicaid in Missouri, mostly children, the disabled and the elderly. The nearly 300,000 who would be added are generally those with jobs that keep them near the poverty level but don’t provide insurance. The governor said there’s something wrong with a system that makes it easier to get health coverage if you don’t have a job than if you do.
    “That, my friends, is just flat-out wrong. We’re at a point where we can do something about it,” he said.
    The expansion comes under the Affordable Care Act, or Obamacare. Starting Jan. 1, 2014, Washington will pick up the full cost of expansion for three years. After that, states would begin to pay part of that cost, capping at 10 percent in 2020. Republicans have questioned whether Congress will keep its word on that, and Nixon says he would be prepared to have the state drop out if Congress changes the funding level. Nixon also pointed to a Missouri Hospital Association study that says expansion would lead to 24,000 more jobs across the state.
    “Three hundred thousand more Missourians covered, 24,000 more jobs – and zero additional expense,” he said.
    In addition to chambers of commerce, hospitals have expressed strong support for the idea, saying it’s key to their survival, particularly those in rural areas. Hospitals get federal money to make up for uncompensated care – St. Mary’s, for example, has historically written off a good deal of care for patients unable to pay – but that money is being phased out. The idea was that Obamacare requires virtually everyone to have insurance, and if everyone is covered, hospitals will be paid. Without the Medicaid part of that equation, hospitals will be hammered financially, advocates say.
    The governor also argues that failing to make the change means Missourians’ taxes, instead of coming back to the state, will go to other states that do expand Medicaid. Most states are doing so. In 2014 alone, the state would get about $1.8 billion.
    “For our state, inaction means fewer jobs,” Nixon said.
    He also said mental-health services would be particularly hard hit, and he said many people facing those issues would be “bouncing back and forth between local emergency rooms and the local jail” rather than getting the care – often simple and preventive care – that they need.
    Page 2 of 2 - Nixon rejected the idea put forth by local Republican legislators in recent days that Medicaid is inefficient and broken and needs to fixed before any discussion of expansion. The opportunity, Nixon said, lies in taking the federal money and using that to strengthen and improve the program.
    “The only practical way ... is to take these dollars and do it,” he said.
    Nixon also pointed to the human cost, saying that many people are comfortable in the knowledge that if they suddenly get sick, they can go to the hospital, show their insurance card and get good care.
    “But there are hundreds of thousands of working Missourians who don’t have one of those cards, who are one illness or injury away from medical bankruptcy,” he said.
    The state is at an inflection point, he said – a straightforward decision but a big one. Look at the communities that didn’t want railroads a century and a half ago because trains are noisy, he said. A century later, some didn’t want an interstate near their town. Even today, some are slow to embrace broadband service – despite the way it’s revolutionizing business and other things. Look at where those communities are now, he said.
    “This decision is one of those decisions – only it’s for the entire state,” Nixon said.

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