• Gov. Nixon urges Medicaid expansion

  • Missouri Gov. Jay Nixon on Thursday stopped in Independence to make his case to expand the Medicaid program, which he and other advocates say is vital to the future viability of health-care providers around the state.

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  • Missouri Gov. Jay Nixon on Thursday stopped in Independence to make his case to expand the Medicaid program, which he and other advocates say is vital to the future viability of health-care providers around the state.
    “I think this is the largest economic development question facing the state of Missouri right now,” the governor told civic leaders gathered at the Independence Chamber of Commerce.
    The governor pointed out that the Independence chamber, like those in most of the state’s largest cities – Kansas City, St. Louis, Springfield, Lee’s Summit – have endorsed his plan, as have the Missouri Chamber of Commerce and Industry and the Associated Industries of Missouri.
    “This is a valuable program. It’s a very much needed program,” said Stan Shurmantine, chairman of the Independence chamber board.
    The Democratic governor said other states – including several with Republican governors – are taking up the federal government’s financial incentives to expand the program. In Missouri, about 900,000 people are on Medicaid – known in the state at MO HealthNet – and the governor says his plan would add another 300,000, taking in those making about one-third more than federal poverty-level wages. For a family of four, 138 percent of the federal poverty level is $31,809, according to the governor’s office.
    “It (expansion) is the smart thing to do,” Nixon said. “It is the right thing to do.”
    Republican leaders in the Missouri General Assembly, who hold large majorities in both houses, have flatly opposed expanding the program, but the governor said he’s met with Republicans and is trying to bring them around.
    “I think we’re in an education process here,” he said, adding that it will be a couple of months before the legislature votes on his budget proposal, which includes the expansion.
    Under the Patient Protection and Affordable Care Act – Obamacare – Congress envisioned extending coverage to millions of the uninsured by expanding Medicaid. Washington would use its share of Medicaid funding to force the states to go along, but when the Supreme Court upheld Obamacare overall last June, in a separate ruling it took away that fiscal stick.
    So Washington has had to turn to a fiscal carrot: It will pay all costs of added coverage for three years, starting Jan. 1, 2014. After that, the states start picking up some of that cost, topping out at 10 percent by 2020.
    In 2014 alone, the change would mean $1.8 billion coming to the state.
    “And quite frankly, I want Missouri dollars to go to work in Missouri,” Nixon said.
    As he has since getting behind the Medicaid expansion idea two and a half months ago, Nixon portrayed his plan as a smart business decision. A University of Missouri study, conducted for the Missouri Hospital Association, found it would create 24,000 jobs in 2014, including 4,236 in five metro area counties.
    Page 2 of 2 - As he has said repeatedly, Nixon said now is not the time to debate Obamacare – the law of the land, he says – but rather how best to move forward. Other states are lining up to get the benefits of expanded care, and he said it would be a poor choice for Missouri to stay behind.
    “Other states get the benefit. We get the bill,” he said.
    Advocates also have pointed to another concern: One of the ideas behind Obamacare was that an expansion of Medicaid would mean large amounts of money coming into hospitals for care that now is often uncompensated – often expensive emergency-room care because so many uninsured people put off care until their condition becomes acute. There are federal funds to help offset those costs, but that money is going away. Without the Medicaid expansion, the arguments, hospitals will be left with less money but no less uncompensated care. That’s a threat to the future of hospitals around the state, advocates have said.
    “A stronger health-care system will make health care available to 300,000 of our friends and neighbors,” Nixon said.
    The change also would help working people who now often neglect preventive care and other medical issues because they have no insurance, Nixon said.
    “They’re praying that they don’t have one injury or illness that could spiral them financially,” he said.

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