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Nixon, Kinder at odds over pending federal health care changes

This article first appeared in the St. Louis Beacon, Jan. 8, 2010 - Declaring "the summer of talking loud is over,'' Gov. Jay Nixon rejected on Friday some Republican legislative proposals that would allow Missouri to opt out of the federal health care changes that the Democratic-controlled Congress is expected to soon approve.

In effect, he asserted that such legislation was "saying you're going to have Missouri secede from the United States" when it comes to health care coverage.

Nixon, a Democrat, added that it made no sense for Missouri "to unilaterally back away from the billions of dollars from the federal government" that are to be used to help pay for expanding health care coverage in the state.

The governor estimated that Missouri is likely to receive at $1.8 billion-$2 billion a year in extra federal financial help.

Nixon's comments were his first detailed observations about GOP opposition to federal health care proposals, with a veiled reference to last summer's feisty congressional town halls filled with conservatives who shouted at some of Missouri's Democratic members of Congress.

The governor's statements also coincided with Friday's release of an "open letter" from Lt. Gov. Peter Kinder, a Republican.

In the letter, addressed to Nixon, Kinder asks, "Will you stand with me and speak out against the tax increases, healthcare takeover and mandates being proposed by the federal government?"

Kinder contended that the federal health care plan approved by the U.S. Senate, and now in conference, "is convoluted and full of provisions that will raise the cost of living for most everyone in our state."

Kinder also asserted that Nixon has "chosen to remain silent on whether you support the efforts of your fellow Democrats in Congress."

In particular, Kinder said it was time for Nixon to speak out against the likely decision of Congress to require low-benefit states like Missouri to expand their Medicaid rolls to cover people who earn up to 133 percent of the federal poverty level. Missouri now generally restricts such benefits to adults who earn no more than 20 percent of the federal poverty level.

Kinder called the likely Medicaid expansion "the mother of all unfunded mandates."

Nixon -- who wasn't aware of Kinder's letter when he talked Friday to reporters and made no mention of it -- said that his administration was closely monitoring the congressional proceedings, but that it was too soon to comment on the federal Medicaid proposals.

For Nixon, the matter is complicated by his stance for years that state Republicans, including his predecessor, former Gov. Matt Blunt, made a mistake in 2005 when they cut or eliminated Medicaid benefits to close to 300,000 low-income and disabled people as part of a state cost-cutting move.

Nixon attempted to restore benefits to about 35,000 failed last legislative session, when the House rejected a deal in which Missouri hospitals agreed to pay higher fees to the state that would be used to leverage more federal Medicaid dollars. No extra state money would have been involved.

Still, Nixon said Friday that he had no plans to resurrect that plan this legislative session.

But Nixon's chief argument Friday against refusing federal health care aid was similar to what he said after the Medicaid cuts in 2005, when he noted that the federal government pays 70 percent of the state's Medicaid costs.

Turning back federal health care money makes no sense, Nixon said, emphasizing that rejecting such aid doesn't cut the federal deficit. "The money would just go to other states."

Jo Mannies is a freelance journalist and former political reporter at St. Louis Public Radio.