Nixon brings Medicaid expansion effort to Perryville

PERRYVILLE, Mo. ­-- It's been another difficult week for Missouri Gov. Jay Nixon's effort to expand Medicaid, but the governor is not slowing down in trying to build support.

Before a large gathering of health-care workers, local businesspeople, law enforcement and government officials Thursday at Perry County Memorial Hospital, Nixon said he believes "good, solid progress" is being made toward expanding the program, which provides health coverage for low-income individuals.

The Southeast Missouri Regional Planning and Economic Development Commission, based in Perryville, is supporting the governor's plan for expansion, as are many chambers of commerce throughout the state, while a Republican-dominated state legislature has repeatedly voted it down.

Nixon's plan would raise the income eligibility for adults, adding up to 300,000 more individuals to the rolls. The federal government would pay 100 percent of the $5.7 billion cost for the expansion for the first three years, with a federal-state cost share after that.

The state's share, according to the governor, would be 5 percent in 2017, and not exceed 10 percent in 2022.

Estimates cited by Nixon also show the expansion would create up to 24,000 new jobs in the state in 2014. Another estimate from the Missouri Hospital Association shows not expanding Medicaid would mean 9,000 fewer jobs in Missouri, more crowded emergency rooms and higher medical bills and insurance premiums.

The governor said on Thursday the need to expand the program is required mostly to aid lower-income working families.

"In our state, work is of value," Nixon said. "We try to reward people who work hard, and right now, the only way you get Medicaid is if you don't work. That doesn't make any sense."

Many state lawmakers are opposed to Nixon's proposal, instead supporting reforms of the current system or a pared-down version of expansion. Expanding Medicaid is a cornerstone of President Barack Obama's health-care law.

In an earlier interview on Thursday, the governor said he's willing to consider an Arkansas model that uses Medicaid money to purchase policies through an online insurance exchange created under the Affordable Care Act.

He called the method Arkansas is attempting to use "one good solid reform."

"I think there's a lot of ways to get this done," he said, adding "I am glad that we are having constructive discussions about how to not only expand Medicaid, but how to improve it."

House and Senate Republicans have been voting against the expansion during committee meetings, and voting down amendments to add federal funds to the state's 2014 budget that would expand Medicaid coverage for adults and add funds for mental health and senior services. Republicans say their biggest concern is sending more money into the budget in the absence of reforms of the Medicaid system.

House Minority Leader Jake Hummel, D-St. Louis, responded to the House's rejection of the amendments to add federal funds to the state budget Thursday in a news release.

"By repeatedly voting against jobs, economic growth and rural hospitals with as much contempt as they can muster, House Republicans are stubbornly cutting off Missouri's nose to spite its face," Hummel said in the release. "Their intransigence notwithstanding, the choice remains a simple one: expand Medicaid and reap the benefits of new jobs and economic growth, or forgo expansion and face the consequences of fewer jobs and closed rural hospitals."

Nixon expressed urgency Thursday when he spoke of the efforts to expand Medicaid and the current situation with the legislature.

"We need to get this done," he said. "The legislative session is past halftime, we are soon into April. It is time to get this moving."

Nixon plans to visit Cape Girardeau on Friday, but he won't be speaking on Medicaid expansion as he did at the Cape Girardeau Chamber of Commerce on March 7. The governor will visit the Southeast Missouri Food Bank to sign Senate Bill 20, which reauthorizes targeted state tax credits for contributions to food banks, child advocacy centers and court-appointed special advocates for assisting child victims of abuse and neglect, according to a release from his office.

The Associated Press contributed to this story.

eragan@semissourian.com

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