This article first appeared in the St. Louis Beacon, March 31, 2009 - Notwithstanding stiff GOP opposition in Jefferson City, Gov. Jay Nixon continues to pursue his campaign promise to expand health coverage for Missouri's uninsured.
On Tuesday, his proposal picked up support from one of the state's most influential business groups, Associated Industries of Missouri. It endorsed the plan at a press conference with Nixon at Boeing Co., in north St. Louis County.
It's unclear whether this backing from business will make a difference in Jefferson City where GOP leaders have consistently said no to Nixon's plan to provide health-care coverage to nearly 35,000 Missouri adults.
The governor, a Democrat, has tried to blunt GOP complaints about cost of the plan by proposing to let the Missouri Hospital Association pick up the bill. In an agreement with the state, the association is offering to contribute an extra $52.5 million a year to a pot to provide care for uninsured Missouri parents.
The state in turn would use that money to draw down an extra $93 million in federal health-care matching dollars. All of these funds would then be used to buy Medicaid coverage for uninsured parents targeted by Nixon.
In calling on Republicans to support this plan, Nixon, a Democrat, is expanding the debate beyond the issue of health care for the uninsured. He is now focusing increasingly on the impact of health-care costs and business development in Missouri.
At the press conference, he argued that health-care cost is one factor preventing companies from moving to Missouri. This cost is rising in part, he says, because many of the state's uninsured get their care in the most expensive way possible: in hospital emergency rooms.
With his health-care reform, Nixon argues that the insured would have an incentive to get regular and routine care in a doctor's office or a clinic. Doctors say Nixon's plan would allow the uninsured to get preventive care and prevent health problems from developing into expensive, full-blown emergencies.
Ray McCarty, president of Associated Industries, was among business leaders who joined the governor at the press conference. McCarty reiterated Nixon's argument that the uninsured place a burden on Missouri's health-care system and drive up health-care cost for both businesses and consumers.
Even though the House has rejected Nixon's plan, and Senate Republicans seem cool to it, GOP spokeswoman Farrah Fite says it's too early to say that Republicans will reject the governor's approach. Fite says Nixon's proposal will compete with SB 306 sponsored by state Sen. Tom Dempsey, R-St. Charles.
"Both proposals seek to do the same thing -- provide health care for the uninsured," Fite said. "It's good if you can draw down more federal follars. Both plans would do that, but it's a question of how you want to use those dollars."
The Dempsey bill would use them partly to help the uninsured buy health-care coverage through the private insurance market.
Fite says the Senate will likely debate both proposals within a couple of weeks and that it might end up with a compromise that combines elements from both plans.
Nixon'sd plan certainly would make it easier for targeted needy Missourians to get care. Under existing Medicaid rules for Missouri, a needy family of four -- two parents and two children -- is eligible only if it makes less than 20 percent of the federal poverty level -- or under $4,410 for a four-person family. Nixon's proposal would allow that same family to get care if it earns 50 percent of the federal poverty level -- or $11,025 for that family.