The Republican Speaker of the state House says future Missouri taxpayers will not be able to afford the expansion of Medicaid.
Governor Nixon says he will include Medicaid expansion in his proposed budget for fiscal year 2014. It would extend Medicaid coverage to those making up to 138 percent of the Federal Poverty Level, or an estimated 300,000 Missourians that are currently uninsured. The expansion would be paid for by federal funds through the end of calendar year 2016.
Speaker Tim Jones says that’s not free money.
“At some point it comes from Missouri taxpayers, and something is going to either have to be cut or taxes are going to have to be dramatically raised to continue to support the president’s health care plan.”
After 2016, the state would take over paying for part of the Medicaid expansion. The state would pay five percent in 2017, six percent in 2018, seven percent in 2019 and 10 percent in 2020.
Jones says that plan can’t be counted on due to the national debt.
“I just spoke with some experts in the health care industry and they told me that 90 percent match could just be, if you read the regulations the right way, it could just be a maximum, which means the federal government could start dialing that back and asking the states to even shoulder more cost.”
Jones cites a study by the Kaiser Foundation, which he says supports Medicaid expansion, that says the expansion would cost Missouri $1.6 billion between 2013 and 2022.
“The Missouri budget is 23 to 24 billion dollars. When you start talking about costs in the billions … I have to ask Governor Nixon, I didn’t notice in any of his fly around press statements today that he described how we were going to pay for this cost.”
Jones also criticizes the governor for not announcing his intention to support Medicaid expansion until after the election. Jones thinks doing it earlier could have hurt Nixon in his reelection bid.
“I don’t know if he would have lost or not … he did win by a comfortable margin. However, this is a hot-button issue and this could have been one of those issues that … if the Governor had come out early enough and said firmly, ‘I am going to be in favor of full Medicaid expansion … full welfare expansion,’ that may have turned the tide of the election and he may not have won reelection.”
Jones notes each time Missourians have been given a chance to vote on something related to the Affordable Care Act, they have rejected it. He also says there are other ways to deal with health care issues.
“That could be done through free market reform, through transformation of Medicaid. We can make the health care system more accessible but there’s going to have to be some reform in the system as well and I’d rather the states completely handle it on their own.”
Jones says the priority should be getting Missourians back to work, though Nixon says the expansion of Medicaid would create 24,000 new jobs in Missouri in 2014 alone.