Calling it the “right thing to do,” Governor Jay Nixon made a strong pitch for expanding Medicaid to more than 300,000 Missourians in his State of the State Address this week. His plea was falling on deaf ears with many Republicans who have vocally opposed such a move.
Citing popular arguments that other states will get the federal money if Missouri rejects the expansion, Governor Nixon reminded lawmakers that several states, such as Arizona, Nevada, and North Dakota, with Republican governors have voiced support for Medicaid expansion. Nixon also pointed out that members of the business community, including the Missouri Chamber of Commerce, have endorsed the expansion.
According to the federal health care law Missouri could get as much as $1 billion federal dollars during the fiscal year 2014 if it expanded Medicaid to 138 percent of the poverty level to certain eligible groups of the population.
The federal government would pay all the costs of expanding Medicaid for the first three fiscal years. Then the states would begin to pay part of the costs until their permanent share would be 10% of the program by 2020.
One of the fears cited by Republican leaders is that the federal government would not honor its pledge and shift more costs to the state over time. Governor Nixon tried to address this concern in his speech by supporting an automatic rollback of the Medicaid program if the federal government didn’t live up to its agreement.
Even this didn’t seem to satisfy Republican leaders. Speaking after the Governor’s talk, House Speaker Tim Jones (R-Eureka) told reporters that he feared that it would not be possible to rollback once Missouri expanded the Medicaid program. Senate Majority Floor Leader, Ron Richard (R-Joplin), indicated that he felt the federal government should show more flexibility for Medicaid expansion.
With lines drawn, the battle over Medicaid expansion will be one of the top issues of the legislative session.