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Koster Calls On Democrats To Fight For Medicaid Expansion, Blasts GOP's 'Angry Stubbornness'

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HANNIBAL, Mo. – Missouri Attorney General Chris Koster –  now running for governor -- dove straight into the health-care debate Saturday when he attacked his former Republican colleagues for opposing Medicaid expansion and the Affordable Care Act.

“The Affordable Care Act was a Republican idea, for goodness sakes,” Koster declared. “They’re just pissed that we stole it.”

Koster’s audience included several hundred at this weekend’s Democrat Days, the annual regional event that traditionally kicks off the party’s campaign season leading up to this fall’s election. He noted that the event was the first Democratic gathering he attended after leaving the Republican Party in 2007 and that he has shown up annually ever since.

In essence, Koster -- the featured speaker at Saturday's brunch -- said that the GOP’s approach to health care, as well as public education and care of the elderly, boiled down to a single thesis: “Survival of the fittest.”

"We Democrats believe in a basic bargain,” he countered. “Our children should be educated. Our sick should have medicine, and our seniors should never live in poverty.”

Although he touched on all three topics, the bulk of his speech centered on health care -- and how it influenced his decision to switch parties.

“There may be no issue with which I disagree more with my former party than the issue of public health,” Koster said, touching off repeated applause. “On issues of medical research, on access to contraception, on expansion of health care to low- and moderate-income citizens…I am still frustrated by my former party’s 1950s-style public-health policies.”

Credit Jo Mannies/St. Louis Public Radio
Missouri Attorney General Chris Koster addresses Democrats on Saturday in Hannibal, Mo.

“Our job as Democrats is to speak clearly on this issue,’’ he continued. “I left the Republican Party over their foolishness on health care... Now, the Hospital Association has left them, the Chambers of Commerce of this state has left them. For god’s sake, even Kit Bond has left them.”

Bond, a former Republican governor and U.S. senator, has been hired by business groups to persuade resistant Republican lawmakers to expand Medicaid in Missouri. The federal government would pay all the additional costs for the first three years and at least 90 percent thereafter. Opponents say the state's costs would still be too high. Many conservatives also oppose expanding the government's role in health care.

Rural Missouri and Medicaid expansion

Koster’s call for Democrats to highlight proudly their support of the federal health insurance law was particularly stunning because many national Democrats, and some in Missouri, have been skittish about it. They believe that the congressional battle several years over the Affordable Care Act contributed to the Democratic election losses nationally and in Missouri in 2010.

Some Republicans believe that emphasizing their continued opposition to the Affordable Care Act and Medicaid expansion could help the GOP this fall.

Koster, however, disagreed. And in Hannibal he appeared to have company from fellow Democrats who said that rural voters – who generally now vote Republican – are coming around on Medicaid, in part because of rural hospitals’ warnings of cutbacks or closings if the expansion is rejected.

The money from the expansion is to replace the federal money, soon to be cut, that hospitals now receive for caring for the uninsured. Rural hospitals, in particular, say they may not survive without federal help.

“The rural hospitals are suffering,’’ said John Yancy, a longtime organizer of Democrat Days and a member of the local county Democratic committee.  That view was echoed by virtually all Democratic attendees asked to name their top issue.

GOP focused on Obama?

Koster said in an interview that he was simply in line with Gov. Jay Nixon, a fellow Democrat, who has lobbied for expansion since shortly after winning re-election late 2012. But there is a difference; Koster is espousing the issue before an election, not after.

Among other things, Koster accused the state’s Republican leaders of  embracing “the same angry stubbornness” that the GOP espoused in its failed legislative efforts in 2005 to ban certain stem cell research. That led to the narrow statewide passage in 2006 of a constitutional amendment protecting such research.

Credit Jo Mannies/ St. Louis Public Radio
Campaign buttons promoting Hillary Clinton for president were the most popular item for sale at Democrat Days, salesmen said.

Expanding Medicaid coverage to roughly 300,000 more Missourians would do more than just improve their health, Koster went on.

“Put aside the lives that this will save. Put aside the healthy outcomes that will result. Put aside the emergency room visits that never should occur,” he told the crowd. “This expansion proposal is still the best darn economic development proposal that this state has seen in the last 25 years.”

He cited health experts’ estimates that Medicaid expansion would bring 24,000 new jobs to the state, as well as the $8 billion in promised federal money over six years.

Koster then concluded, “And for no other reason than because Barack Obama passed it, this legislature is willing to deny the health and economic benefits of  expansion simply to spite a president.”

Democratic candidate for state auditor

For all the focus on health care, Missouri Democrats in Hannibal seemed to spend little time discussing a key party problem as it heads into the fall. With only two weeks left for candidate filing, the Democrats have yet to find a prominent figure to run for state auditor, challenging Republican incumbent Tom Schweich.

State Democratic Party Roy Temple said earlier that he wasn’t focused on the matter. And that appears to also be the case for many rank and file Democrats.

Those in Hannibal seemed more interested in discussing how the party can best cut into the huge edge that Republicans now hold in the Missouri House and Senate. That majority has been built largely by GOP success in decimating the Democratic ranks in rural Missouri.

State Rep. Ed Schieffer, D-Troy, introduced himself Saturday as “the last Democrat in the Missouri House from northeast Missouri.” His few remaining colleagues were ousted in 2012.

Schieffer is now running for the state Senate and says he’s “cautiously optimistic” – in part because of the issue of Medicaid expansion.

As for state auditor, some Democrats were privately contending that Koster -- who now wields significant behind-the-scenes power in state Democratic politics -- opposes mounting a strong challenger to Schweich and is discouraging any major Democrats from filing.

They said that Koster would rather run against Schweich for governor in 2016 and would like to see him well-funded for a possible primary battle against former House Speaker Catherine Hanaway, a Republican from St. Louis County who recently announced she’s running for governor.

In an interview, Koster dismissed such talk as “overly complicated political gossip.”

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