Missouri lawmakers thwart another attempt at Medicaid expansion
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Missouri lawmakers thwart another attempt at Medicaid expansion

Date: March 13, 2013
By: Josie Butler
State Capitol Bureau
Links: SB 349, HB 627

JEFFERSON CITY - Despite the rejection of another bill that would expand Medicaid in the state, Democratic lawmakers said Wednesday they will continue to push for expansion.

Sen. Paul LeVota, D-Independence, said the defeat of his bill by the Senate Appropriations committee on Wednesday is not the end of Medicaid expansion. LeVota said expansion is a good idea for Missouri and testimony at Wednesday's hearing showed overwhelming support for the proposed expansion. Although Medicaid expansion bills have been defeated in both chambers, LeVota said Democrats will try to pass it with an amendment on the floor.

"As time goes on, it will be hard to oppose it," he said.

The bill was defeated in the committee by a vote of 8 to 3. A House bill that would have expanded Medicaid was defeated by the House Government Oversight Committee in February.

LeVota said he promotes Medicaid expansion because Harry S. Truman would have done the same. He said Truman believed the federal government should play a role in health care, saying the health of American children, like their education, should be recognized as a definite public responsibility.

"We need to carry Truman's vision forward to the present day," LeVota said. "I'm not saying this because I'm a Democrat from Independence. A lot of people on all sides of the political spectrum are on this."

Jim Lembke, a lobbyist for United for Missouri and former state senator, said he believes the system is necessary for the state but "profoundly broken." United for Missouri is an organization committed to educating individuals about the impacts of economic decisions.

"It's not a matter of are we going to have a Medicaid program," Lembke said. "But do we expand one that admittedly is broken? I think we fix the program and make sure that we don't continue to pour more money into a bucket with a bunch of holes."

LeVota said Medicaid expansion will pay for itself because the federal government will pay the cost for the first three years. If Missouri does not expand Medicaid, LeVota said tax dollars Missourians pay will be sent to fund health care services in other states.

"This could  be the single largest job creation program in Missouri," LeVota said. He said it would create more than 24,000 new jobs in 2014 in high paying, skilled medical jobs -- "the kind of jobs that bring a bright future to young Missourians," LeVota said. 

LeVota also said his bill included a trigger that would undo the expansion if the federal government fails to "uphold its end of the bargain."

Committee chairman Sen. Kurt Schaefer, R-Columbia, said he believes it is not legitimate to assume that Missouri could kick 300,000 new recipients off of the state Medicaid rolls after three years if the federal government does not continue to pay.

Sen. Kiki Curls, D-Jackson County, said she is in full support of expansion.

"I would rather have insurance for three years than not at all," she said.

Volunteer instructor John Orear testified on behalf of the National Alliance on Mental Illness, a grassroots mental health organization that advocates for services and treatments for individuals with mental illnesses. Orear said he supports Medicaid expansion because his son has a mental illness and could not get health care coverage. After being diagnosed with bipolar disorder in college, Orear said he "started down the rabbit hole of mental illness." He said because the Affordable Care Act had not yet been passed, he did not have health insurance to treat his son. After struggling for two years, he said members in the law enforcement community told him he could get treatment for his son if he pled guilty to a petty crime. After pleading guilty, Orear's son entered the health care system.

"No young person should have to commit a crime to get treatment in the richest nation in the world," Orear said. "Medicaid expansion will get my son  and thousands of other people the treatment they need and deserve."

Pemiscot Memorial Hospital CEO Kerry Noble said if Medicaid is not expanded, many rural hospitals in Missouri will be forced to close. LeVota also said rural hospitals will close and 10,000 hospital jobs would be lost between now and 2021 if expansion does not occur.

Around the same time the Senate committee voted to kill LeVota's bill, another Democrat was offering another vehicle for Medicaid expansion during a House Budget Committee hearing. Rep. Jeanne Kirkton, D-St. Louis City, offered an amendment to the Department of Social Services budget bill that would have expanded the state's Medicaid rolls, but the amendment was defeated by the committee along party lines by a 20-10 vote.

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