Key legislative leaders have declared Medicaid expansion in Missouri 'dead'
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Key legislative leaders have declared Medicaid expansion in Missouri 'dead'

Date: April 17, 2013
By: Josie Butler
State Capitol Bureau
Links: HB 700

JEFFERSON CITY - Despite an intensive push by Missouri's governor to expand the state's Medicaid rolls, two key legislative leaders have declared Gov. Jay Nixon's Medicaid expansion plan "dead" for this year.   

Senate Republican Floor Leader Ron Richard cited President Barack Obama's budget plan as the reason for not dealing with Medicaid expansion this year. The president's proposed budget would delay a cut in federal funding to hospitals throughout the country, that was projected to cost $240 million to Missouri hospitals, however, the budget must first be approved by Congress.

Those cuts would be made to disproportionate share payments, or DSH payments, which the federal government gives to hospitals that provide care for a large amount of uninsured patients. The federal health care law called for a reduction in these payments on the expectation that the number of people without health insurance would decrease. 

Richard said on Wednesday that the conversation over expanding Missouri's Medicaid rolls has been "muted" and discussion of expansion will be pushed back until next year, because Obama's proposed budget has removed the sense of immediacy on the issue.

The Senate leadership's position prompted the Republican's Medicaid expansion bill sponsor, Rep. Jay Barnes, to declare his bill dead.

Barnes, R-Jefferson City, said because the Senate declared Medicaid expansion "dead" his bill has no chance of passage. He said once the Senate says something is dead, it is.

Barnes' bill would change the Medicaid system as well as expanding it to 100 percent of the federal poverty level, which is below the 138 percent called for by Nixon. Barnes stopped the vote on his bill by the House Rules Committee that would have put it before the full House. 

Barnes said that although his bill will not make it to the House floor this session, discussions would continue and he would continue to push for "the best solution."

Richard also said that if Barnes' bill did make it through the House, it would not pass through the Senate because there is not enough time left in the session.

"The timing is on the side of those against Medicaid expansion," Richard said. He said if the issue is brought up again next year, the main focus will be reforming Medicaid first, before expansion. When promoting his bill earlier this session, Barnes had touted it as Medicaid reform rather than simple expansion.

Even though Barnes and Richard have declared the issue dead, some Democrats are still hopeful that Medicaid expansion will pass.

House Democratic Leader Rep. Jacob Hummel, D-St. Louis City, said he believes there is enough time to pass Medicaid expansion and he is hopeful that the Rules Committee will get it to the floor.

"We still haven't created 24,000 jobs and we still haven't provided health care," Hummel said. "The pressure isn't off."

Hummel said that with four weeks left in the legislative session, he sees no reason why it can't be done.

In the past few weeks, Nixon has met with both the House and Senate Republican caucuses to discuss expanding Missouri's Medicaid rolls. Nixon had expressed optimism about expanding Medicaid after both meetings.

Nixon said to a group of reporters after meeting with the House Republicans on April 4 that he believed there was enough time left in the legislative session to push Medicaid expansion through.

A spokesperson for Nixon was not available for immediate comment on Wednesday.

Although Barnes' major Medicaid bill has been declared dead, he has a number of smaller related bills pending before the House. The provisions in Barnes' remaining bills include: extending the sunset on the Ticket to Work program, which provides Medicaid coverage to low income disabled workers who get lower paying jobs, and creating a task force to examine the long term future of Medicaid in Missouri.

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