The Joplin Globe, Joplin, MO

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November 29, 2012

Gov. Nixon notes support for state Medicaid expansion

Gov. Jay Nixon announced his support Thursday for an expansion of Missouri’s Medicaid program via the federal Affordable Care Act to provide health care coverage for an estimated 300,000 Missourians who do not have that coverage.

About the expansion, Nixon said, “It’s the smart thing to do, and it’s the right thing to do.”

State Republicans immediately criticized the plan, saying neither Missouri nor the nation can afford the federal health care act. Lt. Gov. Peter Kinder said the Medicaid expansion would be “ruinous.” House Speaker Tim Jones called it a “big-government program” that would “increase the burden on future taxpayers.” And Senate leader Tom Dempsey said Nixon’s plan is “very unlikely” to pass.

Nixon said he supports a Medicaid expansion for adults earning up to 138 percent of the federal poverty level, as allowed by the Affordable Care Act. A family of four living at 138 percent of the federal poverty level in 2012 makes $31,809 a year.

Because federal funding would cover 100 percent of the costs for calendar years 2014, 2015 and 2016, expanding health care coverage to those 300,000 uninsured Missourians would involve no state tax dollars for those years, Nixon said.

But the state would have to begin paying a 5 percent share in 2017, and it would gradually increase to 10 percent by 2020. It’s that additional future cost to the state that is opposed by Republican legislative leaders responsible for passing a state budget.

The expansion is supported by the Missouri Hospital Association and local hospitals because it would reduce the number of uninsured.

Noting that the Missouri Chamber of Commerce and Industry has endorsed the expansion of Medicaid in Missouri, Dave Dillon, spokesman for the Missouri Hospital Association, said in a telephone interview Thursday: “The business community realizes that if we don’t expand coverage and continue to have a large number of uninsured people, we end up paying a big portion of that tab.

“The business community realizes what can be saved by individuals and businesses by reducing the number of uninsured.”

Currently, hospitals are reimbursed for treating people who have no health insurance. Under the Affordable Care Act, payments to hospitals that serve the uninsured will be reduced. If those payments are not offset by an increase in federal funds to cover the cost of that care, hospitals will have to bear those costs. That would result in the high cost of caring for the uninsured being passed along to employers and individuals who would have to pay higher premiums for their health insurance.

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