The Joplin Globe, Joplin, MO

February 13, 2013

Gov. Nixon says Medicaid expansion would be good business decision

By Susan Redden

JOPLIN, Mo. — Gov. Jay Nixon chose a business setting Wednesday to assert that Medicaid expansion would be a good business decision for the state.

With officials of area hospitals and health care providers standing behind him, Nixon told a Joplin crowd that rejecting the Medicaid expansion available under the Affordable Care Act would send tax dollars collected in Missouri to other states where the coverage has been expanded.

“The question is narrow: Will we bring back those federal tax dollars to help the state or not?” the governor said in a presentation at the Robert W. Plaster School of Business at Missouri Southern State University. “If we don’t, other states will get the help, and we’ll pay the bill.”

If approved by the Legislature, the proposed expansion would add 300,000 Missouri residents to Medicaid rolls, with the federal government paying all the costs for the first three years.

Nixon said the expansion would improve the state’s economy, pointing out that the plan has been endorsed by chambers of commerce and business groups across the state. The proposal has been roundly criticized by Republican leadership in the Missouri General Assembly, but Nixon said GOP governors in Ohio, Michigan and other states recently announced support for Medicaid expansion.

GOP lawmakers say the state cannot afford to pay for its share of the proposal, so any expansion likely would result in cuts in other areas, such as education.

“This transcends politics,” he said. “And the people it will help are working folks who otherwise are going to end up in the emergency room.”

The expansion also has the backing of hospitals and health care providers in the state. Nixon met with officials of Freeman Health System, Mercy Hospital and others before his presentation.

Paula Baker, president of Freeman Health System, said the session was primarily to review the points Nixon would be making in the presentation.

“He didn’t need to sell us on it,” Baker said.

Expanding the Medicaid rolls wouldn’t just keep more people out of emergency rooms, it would increase the number of people who can get the kind of preventive care that can keep them healthy, said Darlene Sarley, clinic manager at Access Family Care, 530 S. Maiden Lane.

About 40 percent of the patients seen at the Joplin clinic — where patient numbers exceeded 1,500 in January — are on Medicaid. The remainder pay costs determined by a sliding scale based on income.

That out-of-pocket cost often will keep people from getting the screenings and preventive treatments that could save their lives, Sarley said.

“So any time you can increase the number of people getting regular health care, it will make a big difference,” she said.

Patricia Bailey, who was at the clinic for a checkup Wednesday, agreed. She said she likes the idea of more people being able to get Medicaid coverage.

Bailey, 61, of Joplin, said she has been on Medicaid for the past four years. Without it, she said, she wouldn’t have sought treatment that included three hospitalizations.

“I couldn’t have afforded it. I think I’d probably be dead,” she said.

Don McBride, chief executive officer for Access, said he sees the proposed expansion as “a real health care benefit for many Missourians.”

Nixon cited a study by the University of Missouri suggesting that the additional funding for health care would create 24,000 new jobs in Missouri the first full year of the expansion. And, he said, states that don’t expand coverage could be put at a competitive disadvantage when small businesses are looking to add jobs, which often start on the lower end of the wage scale.

“If businesses are paying the same wage, and workers are getting health coverage in one state and not another, it could make a difference,” he said.

Medicaid expansion is projected to bring back to the state $1.8 billion in the first full year of coverage, and $5.7 billion over three years, Nixon said. “If we take a pass, Missouri residents pay that money in taxes, but it goes to other states,” he said.

Nixon said he would favor legislation enabling the coverage that would also allow the state to make changes if federal promises are not kept.

According to a release from the governor’s office, savings created and revenue generated as a result of the expansion are estimated at more than $46 million in 2014, $125 million in 2015 and nearly $140 million in 2016.

Under the proposed expansion, low-income Missouri residents who cannot afford health insurance and earn less than 138 percent of the federal poverty level would be eligible for coverage. For a family of four, that translates to an income of $31,809 per year.


THE MISSOURI CHAMBER OF COMMERCE and chambers in a half-dozen cities have endorsed the Medicaid expansion. The Joplin Area Chamber of Commerce has not yet taken a stance but will begin discussions soon, according to Rob O’Brian, chamber president, who was at Wednesday’s gathering.