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Nixon Predicts Exodus Of Young Workers Unless Medicaid Is Expanded

UPI/Bill Greenblatt

Missouri Gov. Jay Nixon is trying a new pitch in his quest to persuade state legislators to expand the state's Medicaid program and accept the $2 billion a year in extra federal money that would go along with it.

Nixon told supporters Thursday night in St. Louis County that the state’s current Medicaid program is so stingy that it discourages people from working — and could drive entry-level workers to other states that are expanding Medicaid.

Missouri now bars Medicaid coverage for anyone who earns more than $2,217 a year — which boils down to $42.63 a week.

The result, the governor said, is that the current low benefits penalize people who work in low-paying jobs without health benefits — the target audience under Medicaid expansion.

“The tragic reality is that, right now, the only way for these folks to get access to the affordable health coverage that they need would be to stop working,” the governor said. “When it is easier to get health care by losing a job than by taking one, that’s a real problem.”

Nixon’s audience was made up of about 100 allies, many of them elected officials and health-care providers, gathered at the Greater St. Mark Family Church in north St. Louis County.

In his address, Nixon asked for help in persuading Republican legislative leaders, who so far oppose expanding the state's Medicaid rolls.  Those leaders oppose expanding the government's role in providing health care coverage, and generally doubt whether the federal government will follow through with its promised financial help.

Nixon has been pressing to expand Medicaid since shortly after his re-election in November 2012.  But his focus previously has been primarily on the 24,000 new health-care jobs that experts say the expansion would bring to Missouri and on the generous federal assistance.

The Affordable Care Act calls for the federal government to cover all the expansion costs for the first three years, through 2016, and then at least 90 percent thereafter. Nixon noted Thursday that Missouri already is missing out on the 2014 federal payments.

Budget chief  lays out financial benefits

Unlike other earlier public appearances on the topic, this time Nixon was accompanied by state Budget Director Linda Luebbering. She said afterward that Thursday’s event was the first time that she has joined the governor to bolster his case for Medicaid expansion.

Luebbering focused on the fiscal numbers. Among other things, she said that the additional 24,000 jobs would generate at least $40 million a year in new state tax revenue.

Luebbering’s numbers also highlighted how the state’s current, more austere, Medicaid program works.

Of the 829,000 Missourians currently on Medicaid, about 60 percent – 503,000 – are children. Of the rest, 158,000 are people with disabilities, 75,000 are elderly, 72,000 are low-income adults and 21,000 are low-income pregnant women (many of whom will lose coverage after they give birth.)

Luebbering emphasized that the federal government covers 63 percent of the current program’s cost, with the rest covered by the state. 

She also reaffirmed what she has said before: Some of the state’s current costs — about $77 million a year -- can be shifted to the federal government if Missouri expands Medicaid.

Nixon said he brought along his budget chief because he wanted to lay out the undisputed facts. “The opponents are having to twist their logic and their words,’’ he said.

Credit Provided
Missouri Budget Director Linda Luebbering

He advised his audience, which included some local Democratic legislators, to counter the GOP’s arguments “clearly and respectfully.”  The governor added that it also was necessary “to be relentless’’ and persistent in making the case for Medicaid expansion.

Nixon pointed out that most of Missouri’s neighboring states, with Democratic and Republican governors, are expanding Medicaid and taking the federal money. The upshot, he said, is that within a few years, it will be clear to young entry-level workers that they would be better off going to Illinois, Arkansas, Iowa or Tennessee.

In those states, low-income workers can accept jobs with health benefits — and qualify for Medicaid coverage.

Within a few years, Nixon said, that exodus of young workers will hurt Missouri’s ability to compete.

But the biggest reason to expand Medicaid, Nixon said, was that it was the right and compassionate thing to do.

“Never in my 27 years of public service, and probably never again my lifetime, will we have an opportunity to do this much good health at this low cost,” he concluded. “Our action will get us to the promise land and get us to the place where hope and opportunity and health is something that working people in this state have as their right.”

Jo Mannies has been covering Missouri politics and government for almost four decades, much of that time as a reporter and columnist at the St. Louis Post-Dispatch. She was the first woman to cover St. Louis City Hall, was the newspaper’s second woman sportswriter in its history, and spent four years in the Post-Dispatch Washington Bureau. She joined the St. Louis Beacon in 2009. She has won several local, regional and national awards, and has covered every president since Jimmy Carter. She scared fellow first-graders in the late 1950s when she showed them how close Alaska was to Russia and met Richard M. Nixon when she was in high school. She graduated from Valparaiso University in northwest Indiana, and was the daughter of a high school basketball coach. She is married and has two grown children, both lawyers. She’s a history and movie buff, cultivates a massive flower garden, and bakes banana bread regularly for her colleagues.