This article first appeared in the St. Louis Beacon. - After months of lying low on the topic of Medicaid expansion, Missouri Gov. Jay Nixon appears to be resurrecting the issue with Tuesday's invitation to General Assembly leaders to join him “for a discussion about reforming our state’s health-care system to provide better outcomes for patients and better returns for taxpayers.”
The meeting is set for Nov. 26, two days before Thanksgiving. The invitation is directed at the bipartisan members of the state House and Senate interim committees on medicaid transformation and reform.
While not using the word “expansion,’’ the Democratic governor hints that the topic will likely be brought up as the Republican-controlled General Assembly prepares for a new legislative session in January.
A year ago, Nixon -- fresh from his successful re-election -- barnstormed the state to press the General Assembly to approve expanding Medicaid, as recommended by the federal Affordable Care Act, also known as Obamacare.
Nixon had emphasized that the federal government would pay all the expansion costs for three years, beginning in 2014, which would result in nearly 300,000 Missourians -- mainly working poor -- being added to the state's rolls. The federal government would pay at least 90 percent of the cost after.
Republican legislative leaders have objected to the expansion on philosophical and financial grounds. However, as the expansion kicks in roughly half of the 50 states in a few months -- including some with Republican governors -- Nixon appears to be making a renewed push.
Some business and hospital groups, including the Missouri Chamber of Commerce and Associated Industries of Missouri, may bolster his efforts.
In his invitation letter, Nixon lauded the two legislative committees’ public meetings over the summer on how to revamp the Medicaid program. “This is an important issue, so I appreciate the time and effort your committee has dedicated to exploring the strengths and weaknesses of our current system and the innovative models being pursued in other states so that we devise the best approach for Missouri,” the governor wrote.
He then alluded to some of the hearings’ attendees “who spoke clearly about the benefits a stronger Medicaid system would yield for our economy and for the hundreds of thousands of working Missourians who need health insurance coverage.”
“As the interim committees begin to wrap up their work, it is my hope that this meeting will give us an opportunity to engage in a thoughtful, productive discussion about charting the best course forward on one of the most pressing issues we will face next session,” the governor continued. “In addition to presenting my ideas for making our health care system more efficient and effective, I look forward to taking your questions and hearing about what you have learned through this process.”
Republican leaders have said little since the invitations were sent out -- until House Speaker Tim Jones' response issued late in the day. Jones, R-Eureka, made clear that he's still no fan of expanding of Medicaid.
“While the Republican super-majority in the Missouri General Assembly has refused to accept a misguided and inappropriate expansion of the broken Medicaid system, we have continued to work diligently to transform the system so that it capably serves those who are truly in need," Jones said.
"The undeniable truth is that we do want to ensure access to quality health care for our most vulnerable citizens. We simply refuse to put our stamp of approval on a massive expansion of a badly broken Medicaid system that fails to provide basic, baseline care to current participants, threatens to severely slash our education budget for our children and is a terrible value for taxpayers."
He added, "The argument for pumping billions of new tax dollars into the Medicaid system takes on a different light when you look at the facts of how poorly the system performs. Instead, the current Medicaid system’s many inadequacies make it even more imperative that we place our emphasis on actual, meaningful reforms that will improve health-care outcomes for those the system is meant to serve. Others may think slapping a billion-dollar Band-Aid on a broken system that continues to be exacerbated by the daily failings of Obamacare makes sense, but we see any plan that fails to emphasize true reform as a monumental waste of taxpayer dollars.”
