This article first appeared in the St. Louis Beacon, March 14, 2013 - Before leaving the state Capitol for a one-week recess, the state Senate’s Republican leaders have issued a joint statement declaring, in effect, that there’s no way they will support an expansion of Medicaid.
Among other things, the leaders – including Senate President Pro Tem Tom Dempsey, R-St. Charles – say they don’t trust the federal government to pay its share of the costs. Under the Affordable Care Act, the federal government is to pay all the costs of the Medicaid expansion for three years, and then at least 90 percent thereafter.
“An expansion of such a large program with a partner as unreliable as the federal government would likely mean future tax increases or serious cuts to vital priorities, like K-12 education," the joint statement says.
The statement includes the unverified assertion that the state’s share of the costs could reach $1. 2 billion by 2022. The Nixon administration has disputed that figure, saying the funding formula would cost the state a fraction of that amount.
The senators also cite the 2010 statewide vote in favor of Proposition C as evidence that the public sides with them. Prop C sought to exempt the state from the federal mandates in the Affordable Care Act. About 70 percent of Missouri voters backed the measure in the August 2010 primary.
Of the five senators signing the letter, two others besides Dempsey are from the St. Louis region: Majority Caucus chairman Eric Schmitt, R-Glendale, and Majority Caucus whip Brian Nieves, R-Washington.
The letter, issued Thursday, appears to be in response to the Missouri Chamber of Commerce’s call on Wednesday for the state to participate in the voluntary expansion, or face the prospect of hospitals closures.
The Missouri Hospital Association has issued a study stating that its members stand to lose $4.2 billion in federal subsidies over the next six years that now help cover the costs of uninsured people who show up for care. The subsidy is to be stopped because of the expansion, whether or not a state participates.
The senators noted that the state Senate has passed a resolution “calling upon Congress to continue this funding.”
The Senate leaders also called on Congress to send “block grants issued to the state to develop its own plan” for providing health coverage for the poor. “Missourians know what works best for them better than any Washington D.C. bureaucrat,” the statement said.
At the same time, the statement also blasted the federal government for overspending.
The senators then concluded by calling on Gov. Jay Nixon, a Democrat, to end his pro-expansion tour around the state: “We call upon the Governor to begin working toward a common-sense, Missouri solution instead of an irresponsible, comprehensive adoption of failed federal policies.”
The governor plans to be in Warrensburg on Friday, continuing his call for the Medicaid expansion.
Nixon also fired off a Tweet shortly after the Senate leaders issued their statement, implying that he hasn't given up on them: "Hope Senate Republicans are serious about Medicaid reform. Need to bring Missourians' tax dollars back home, not send them to other states."
(Update) On Friday, the governor issued a more detailed statement on the subject, saying he was "encouraged that members of the House and Senate are looking at this issue and share my interest in reform, because that is what strengthening Medicaid will do."
"Bringing these dollars back to Missouri will give us an opportunity to reduce premiums, reward hard work, promote personal responsibility and make sure emergency rooms are for real emergencies," the governor continued. "Strengthening Medicaid will also help people with severe mental illness get the care they need, before they become a threat to themselves or others.t I look forward to continuing to work with the General Assembly to make our health system as efficient and effective as possible by bringing the tax dollars Missourians send to Washington back to work here in Missouri." (end update)
