[Nfbmo] FW: Nixon optimistic that Missouri Republicans may come around on Medicaid expansion

McMahon, Cory J cory.j.mcmahon at gmail.com
Mon Feb 25 16:36:42 UTC 2013

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Subject: Nixon optimistic that Missouri Republicans may come around on
Medicaid expansion

Nixon optimistic that Missouri Republicans may come around on Medicaid
expansion In Region By Jo Mannies, Beacon political reporter
5:05 pm on Wed, 02.20.13
Missouri Gov. Jay Nixon struck a note of optimism Wednesday about his push
to expand Medicaid in the state, even as the Missouri House has excised the
proposal - and the $2 billion in federal aid - from the budget for the
coming fiscal year.

At an appearance in St. Charles County, the governor said, "It's pretty
clear to me we're making progress, first of all. I think that progress will
be seen by next week in the House when that Republican majority introduces a
measure to move forward in this area."

While he doesn't expect the GOP bill to "be exactly what we would want,''
Nixon, a Democrat, said the fact that House Republicans were focusing on
health care was, nonetheless, "a concrete step to move forward."

Nixon even avoided any criticism of state House Speaker Tim Jones, R-Eureka,
who has been outspoken in his opposition to the expansion - and made
frequent verbal jabs at the governor.

"Speaker Jones has appointed a committee to look at this, they're doing
solid work," said Nixon, who met privately with the speaker earlier this
week. "I think Speaker Jones continues to look at these issues. I think he
also is seeing the economic impact of moving forward."

Reminded of the hefty criticism directed at his Medicaid proposal at last
weekend's statewide GOP gathering in St. Louis, the governor added with a
chuckle, "If I just worked with politicians based on what they said at their
political rallies, and pounded on the table, I wouldn't get anything done in
this job."

Nixon cites other GOP governors' support Speaking broadly, the governor
observed, "The challenge we've had is to escape the binary choice that
happened in November (during the election), when you were 'fur it or agin
it.' "

What has helped, he said, is that several Republican governors in other
states - Nixon cited John Kasich in Ohio and Rick Snyder in Michigan -
recently have decided that their states will participate in the Medicaid
expansion called for in the federal Affordable Care Act, the signature
legislation of President Barack Obama's first term.

Referring to the GOP governors, Nixon said, "They're doing this - not
because it's the easiest thing to do politically. They're doing it because
it's the right thing to do."

Nixon appeared before a generally supportive crowd of businesspeople,
health-care professionals and educators at the St. Charles County Economic
Development Center. The stop was the latest in a series around the state to
promote the proposed Medicaid expansion.

The governor's chief talking points have been that:

The federal government has promised to pick up the entire tab for three
years; Missouri is projected to gain an estimated 24,000 new
health-care-related jobs in just the first year; And adding 300,000 more
Missourians to Medicaid rolls would result in a healthier workforce and more
economically stable hospitals.
On Wednesday, Nixon also described the $5.7 billion in federal dollars that
would be sent to Missouri to cover the first three years of the expansion as
money that originated in Missouri taxpayers' pockets.

Beginning in 2017, the state would take on a share of the costs, which would
be phased in -- but not exceed 10 percent by 2020.

"The question before us is a narrow one," the governor said. "Will we bring
the tax dollars we send to Washington back home to strengthen our Medicaid
system here in Missouri? Or will we let those tax dollars that Missourians
send to Washington be sent to other states to spend?"

"Other states get the benefits. We get the bills," Nixon declared.

He emphasized that the 300,000 added to the Medicaid rolls would be largely
"working Missourians who simply can't afford health care.can't afford to go
to the doctor'' and who end up in hospital emergency rooms if they become
seriously ill.

Such scenarios drive up the costs for hospitals forced to care for people
without insurance, he said, and for insured Missourians hit with higher
premiums that are used to offset the costs of the uninsured.

"Seizing this opportunity is good common sense, good fiscal sense," Nixon

So far, the Republican-controlled General Assembly hasn't been buying that
pitch - even with pressure from rural hospitals, which are warning that they
may close if the Medicaid expansion fails to come to pass in Missouri.

Jones and other Republican leaders maintain that government should have less
involvement in the delivery of health care, and the federal government is
too broke to advance such an expansion of an entitlement program.

A shift in the GOP's anti-Medicaid mood?
But some of Wednesday's attendees thought that the political mood may be
changing. "It sounds like the momentum is building for support of this
initiative,'' said Gregory Prestemon, chief executive of the St.
Charles Economic Development Center.

He was struck by Nixon's list of business supporters, which includes the
Missouri Chamber of Commerce and a number of local affiliates.
Prestemon noted that he hadn't heard before of their endorsements.

Laura Heebner, chief executive of Crider Health Center - which serves the
uninsured in St. Charles County -- said she's also seen a slight shift.

A few weeks ago, when she was in Jefferson City, Heebner said that
Republican legislators flatly said there was no way they would support
Medicaid expansion - "period."

But during her latest visit, Heebner was told, "Well, if the bill comes to
me, I will read it."

Even that slight change is giving Heebner some hope: "I think the
conversation is shifting."

Nixon observed that even Republican critics "certainly don't want Washington
running our health-care system."

"And if we don't move forward on this," he asserted, billions of Missouri
health care dollars will go to Washington "and they're making the choices."

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