It appears the House is set to reject Governor Nixon’s proposal to expand health care coverage even though it won’t cost the state anything.

Governor Nixon announced the plan earlier this month during news conferences held at health centers across Missouri. Nixon has reached an agreement with the Missouri Hospital Association to raise a tax hospitals pay by a total of $14 million, allowing the state to draw down $93 million from the federal government.

"This is a tremendously good idea and a generous offer by Missouri’s hospitals," says Rep. Chris Kelly, a Democrat from Columbia. Kelly, though, hasn’t been able to convince majority Republicans, though he holds out hope minds still can be changed.

"The extreme right in the Republican Caucus is driving the Republican Caucus away from rationality," according to Kelly who says hospitals have agreed to the plan, because it makes financial sense. Hospitals, according to Kelly, have to absorb the cost of the uninsured. He says it makes sense then to raise a tax they are paying to expand health care coverage to nearly 35,000 Missourians.

Under the plan, the tax hospitals currently pay would increase in order for Missouri to qualify for the $93 million. Hospitals also would not seek $32 million in reimbursement the state would normally provide as partial payment for treating the uninsured. The governor’s office says all that is needed to increase coverage is for Medicaid eligibility in the budget to be increased from the current 19% of the federal poverty level to 50%. That though isn’t in the current budget set to come to the floor for debate this week.

At present, a single parent with two children qualifies for Medicaid if her income doesn’t exceed $292 a month. The proposal by the governor would increase that to $763 a month.

The legislature created the medical service provider tax in 1992 to draw down federal dollars. Kelly, who served in the House previously, sponsored the legislation, carrying it on behalf of then-Governor John Ashcroft, a Republican. Kelly says it’s the most significant legislation he has ever sponsored, saving the state billions of dollars over the years.

Kelly says it seems apparent that supporters of the plan have some more educating to do to get it to pass this session.

Download/listen Brent Martin reports (1:10 MP3)