Hundreds of e-mails support Lt. Gov. Peter Kinder's lawsuit over health care reform

More than 1,000 Missourians responded to Lt. Gov. Peter Kinder's announcement he plans to challenge the federal health care overhaul enacted last month, a spokesman said Friday.

More than 500 e-mails arrived in the hours after Kinder appeared on Fox News' "On the Record" program, spokesman Gary McElyea said, with only a handful opposed to Kinder's effort. Kinder said he is going to raise private donations to pay attorney costs and file the lawsuit by the end of the month.

"The attorney general did not think pursuing the case is a good use of taxpayer dollars, and he is not going to pursue it," McElyea said. "We decided not to put the burden on taxpayers, but let's let their voices be heard."

There is no initial goal for the fundraising effort, but substantial funds will be needed, McElyea said.

"We want to make sure we have somebody who is competent and qualified for this case and gives it the attention it deserves," he said.

Kinder at first announced he planned to join the lawsuits filed by Florida's attorney general and others challenging the constitutionality of the overhaul law. But he now intends to file his own lawsuit, citing the effect on senior citizens and what he considers an excessive new burden on Missouri taxpayers.

"I have a statutory obligation as the chief advocate for our state's senior population," Kinder said on Fox News. "Seniors are going to be hurt perhaps among the worst of any segment of the population by this ill-conceived, misbegotten federal health care reform that will devastate our state's budget, that will rob from Medicare and thereby hurt seniors, that will cause practitioners to quit the practice of medicine and send millions of new people into their offices, into a shrinking pool of providers."

Kinder said the health care overhaul will cost the state $500 million annually for its share of an expanded Medicaid program.

Statements questioned

Some of Kinder's statements about the effect of the health care bill, however, are being questioned, both by the state agency responsible for Medicaid and the AARP, which supported the health care bill as a good deal for senior citizens and others it represents.

A memo examining the cost issued by the Missouri Department of Social Services estimates that the state will pay an extra $375.3 million from this year until 2019. There will be no additional cost until 2017. A memo detailing the costs further into the future, for 10 years starting in 2014 when the Medicaid changes take effect, gives a total cost of $1.34 billion.

The estimate is based on an assumption that all 255,000 Missourians who would become eligible under the bill would enroll in Medicaid, said Scott Rowson, spokesman for the department. The bill increases the income eligibility limit for adults from $3,504 per year for a family of three to $24,352 per year.

"This is the lion's share of whatever the state costs would be," Rowson said. "This is the primary focus. There will be other elements, but this is the one we are most interested in getting an estimate for now." Rich AuBuchon, chief of staff for Kinder, said he doesn't trust the estimates. The estimates have been changing throughout the debate on the bill, he said, and don't take into account other aspects of the bill that could drive up the costs.

"It is very hard to rely on their figures," he said. "What we are seeing from them is a nonallowance for provider rate increases."

AuBuchon also said government agencies are poor estimators of costs. "It is very difficult for government to project its own costs."

Senate Appropriations Committee chairman Rob Mayer, R-Dexter, said he shares Kinder's concern about the budget effect of the health care bill. The higher eligibility requirement will make it more difficult to control state spending in lean years, he said.

"It's already a challenge for the state to balance its budget," Mayer said,

On the sideline

AARP doesn't see any reason for its members to complain, said Craig Eichelman, state director for Missouri. The organization, which enrolls people age 50 and older, has no opinion on Kinder's plans, he said. "That is going to play itself out, and we will sit on the sideline and watch that happen," he said.

But elements of the bill will mean better, cheaper insurance for people over 50, Eichelman said. The bill bars price discrimination based on age or pre-existing conditions, makes preventive services such as cancer screenings and wellness checkups free for Medicare recipients and closes the "doughnut hole" in the Medicare Part D prescription plan.

"There are myths and there are truths, and these are the real benefits for our members that I hope rises above the clutter," Eichelman said.

Gov. Jay Nixon and Attorney General Chris Koster, both Democrats, have not joined in the call for a lawsuit. Jack Cardetti, a spokesman for Nixon, declined to say whether the governor supported the bill. Instead, he said Nixon will be concentrating on implementing the measure in Missouri. "The debate on whether it should have passed is over," he said.

A lawsuit over the bill's effect on Missouri would be the responsibility of the attorney general, Cardetti said.

A call to Koster's office was not returned.

There is precedent for state officials to sue without the assistance of the attorney general, AuBuchon said. State Auditor Margaret Kelly, for example, sued over the definition of what should be considered state revenue under tax limitations. She lost, but the case wasn't thrown out.

If Koster wants to handle the case, Kinder would gladly turn it over to him. Kinder is only planning his lawsuit because Koster won't act, AuBuchon said.

rkeller@semissourian.com

388-3642

Pertinent addresses:

Missouri State Capitol Building, Jefferson City, MO

U.S. Capitol Building, Washington, D.C.