Retired U.S. Sen. Christopher “Kit” Bond, R-Mo., is jumping into the Jefferson City debate over Medicaid expansion – and he’s on the side of Gov. Jay Nixon and other expansion supporters.
Bond, a former two-term governor, has been hired as a lobbyist by the Missouri Chamber to try to persuade fellow Republicans in the General Assembly to drop their opposition and agree to take the federal aid which would cover all the expansion’s costs for three years and at least 90 percent thereafter.
Nixon said earlier this week that expansion would add roughly 300,000 uninsured Missourians to the state’s rolls.
Dan Mehan, chief executive of the Missouri Chamber, said in an interview that he hopes Bond "gives some comfort to Republicans that this is not a bad idea."
Bond said in an emailed statement Friday that he was getting involved out of concern over what Missouri’s non-participation would do to businesses and rural hospitals.
“While I was and still am one of the loudest opponents of Obamacare, I’m getting involved in Medicaid reform now because if our state sits on the sidelines I’m concerned hospitals in rural and inner city Missouri won’t survive,” Bond said in his email.
Whether Bond can influence Republican legislative leaders is unclear. All publicly balked at Medicaid expansion earlier this week after Nixon's renewed call for the state to participate. On Friday, most GOP officials were silent Friday as news emerged of Bond's entry into the fray.
Mehan said Friday that Bond was the best messenger to reach GOP leaders. “Republicans in the Missouri General Assembly are the ones that are the most hesitant about the expansion and there are few Republicans that are as respected as Sen. Bond,” Mehan said.
Mehan declined to say how much Bond was being paid for his services.
Mehan emphasized that being in favor of Medicaid expansion doesn't mean the Chamber supports the federal Affordable Care Act, the broader law that includes the expansion. The law also sets up the health insurance exchanges.
“We opposed Obamacare, and every day it seems like we see more and more problems with the law,” Mehan said. “But it is the law, it’s been upheld by the courts and it is not changing anytime soon. We need to make the most of the cards we’ve been dealt and do what we can to bring back to Missouri the millions of dollars our taxpayers are putting into it and use it as an opportunity to secure reforms to the system as well. Until the overall law is changed, that is the only fiscally responsible thing we can do.”
Joe Pierlie, chief executive of the Missouri Primary Care Association, is Bond’s former health care adviser during part of his Senate tenure.
“His willingness to take this on doesn’t surprise me at all,’’ said Pierlie, whose association represents community health centers around the state – one of Bond’s key projects when he was in the Senate.
Bond, said his former aide, “is a realist.”
Bond cites the penalties facing businesses with 50 or employees, as of 2015, if they fail to provide health insurance, according to the mandates in the Affordable Care Act. Some of those workers might qualify for Medicaid if it were expanded.
As for Missouri rural hospitals, he cites figures showing that they lost $28 million in 2013 and expect to lose $58 million in federal money in 2014. That money is reimbursement for the costs of caring for the uninsured, but that money is being cut as the federal Medicaid dollars kick in – whether or not a state participates.
By 2019, rural hospitals are facing cuts of $208 million a year, according to Bond’s staff.
Mehan said that a new study by the Commonwealth Fund shows that "Missouri stands to lose $2.2 billion a year in federal money by 2022 if the state chooses not to expand Medicaid under the Affordable Care Act."
Nixon's proposed budget for the 2015 fiscal year estimates that Missouri would receive $1.7 billion to expand Medicaid, while also saving at least $77 million in general-revenue spending that could be shifted to federal Medicaid dollars.