Mo. Gov. Nixon backs expanded Medicaid; GOPs don't

JEFFERSON CITY, Mo. (AP) Breaking months of silence on the subject, Democratic Gov. Jay Nixon on Thursday embraced a broad expansion of Medicaid health care coverage for working adults, but his support was met with immediate criticism by Republican legislative leaders.

Nixon had remained noncommittal during his recent re-election campaign about the multi-billion-dollar Medicaid expansion called for under President Barack Obama's health care law. But Nixon said Thursday that he had analyzed the plan since the Nov. 6 election and concluded that expanding Medicaid to an estimated 300,000 additional people was both "the smart thing" and "the right thing to do."

Top Republicans reacted with resounding disapproval.

House Speaker Tim Jones said Nixon's proposal is probably dead on arrival in his chamber. Sen. Tom Dempsey, who is in line to become Senate president pro tem, said it's "very unlikely" that Republican lawmakers would approve a plan that encourages "an ever-expansive federal government."

Under a Supreme Court ruling earlier this year, each state can decide whether to expand Medicaid to adults earning up to 138 percent of the federal poverty level, as allowed under the federal law. The federal government would pay the full cost starting in 2014, but states would have to begin paying a 5 percent share in 2017 that would gradually increase to 10 percent by 2020.

Nixon vowed to "work tirelessly" to persuade lawmakers that the Medicaid expansion makes sense financially and would improve the health of thousands of their constituents.

"If we take a pass on billions of health care dollars dollars that come out of Missourians' paychecks that money will go to some other state. They'll get the benefit, and we'll get the bill," Nixon said in a conference call with Capitol reporters. "That's not smart, and that's not right."

Cost estimates for the proposed Medicaid expansion have varied greatly.

Nixon's administration said Thursday that it was still working on those numbers. A report released Wednesday by the Missouri Hospital Association and the Missouri Foundation for Health estimates a Missouri Medicaid expansion would cost the federal government $8.2 billion and the state $333 million between 2014 and 2020. A report released earlier this week by the Kaiser Family Foundation and Urban Institute projected the federal government's cost at $17.8 billion and the state's share at $1.6 billion from 2013 to 2022.

Republicans said that's more than either the deficit-plagued federal government or the budget-crunched state government should be spending.

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Mo. Gov. Nixon backs expanded Medicaid; GOPs don't

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