Lawmakers, Nixon meet on Medicaid

Missouri Gov. Jay Nixon met with the state Senate's Republican Caucus Tuesday morning, in his continuing effort to get lawmakers to approve expanding Medicaid in the state.

"Making sure that we bring tax dollars that Missourians send to Washington back to Missouri, by strengthening Medicaid, is the most important issue facing our economy and our state, today," Nixon told reporters in his Capitol office.

"Like my meeting with the House Majority Caucus last week, today was an opportunity to discuss ways to move forward and strengthen Medicaid in Missouri, the Missouri way."

The federal Affordable Care Act - commonly called "Obamacare" - envisioned state expansions of the joint federal-state Medicaid program to serve low-income families up to 138 percent of the federal poverty level.

When the U.S. Supreme Court ruled last summer that Congress has the authority to require all Americans to buy health insurance, it also ruled that states have the option of approving the Medicaid expansion, or rejecting it.

The AARP this morning will release results of a survey showing a majority of Missourians support expanding the number of people served by Medicaid.

And Medicaid supporters plan a rally at the Capitol next Tuesday.

Nixon told reporters his nearly hour-long meeting with the Senate's GOP members Tuesday morning "was a good, solid, thoughtful, open discussion."

But no one said any minds were changed.

Senate President Pro Tem Tom Dempsey, R-St. Charles, told reporters: "I think he gave his most persuasive argument to date to the Republican Caucus, as to why he believes we need to move forward on Medicaid expansion.

"And he respectfully answered every question that members asked."

Both Dempsey and House Speaker Tim Jones, R-Eureka, have been saying for most of this session that Medicaid expansion is a bad idea with little hope of becoming part of state law or the state budget.

"What I have talked to the caucus about, throughout," Dempsey said after Tuesday's meeting, "is that we're going to continue (talking about Medicaid), because this subject is not going to go away at the state level, nor is it going away at the federal level. ...

"Over the next five weeks, we'll continue to have discussions, both in caucus and, potentially, on the floor of the Senate."

Nixon said Rep. Jay Barnes' House Bill 700 is the most likely measure to be used for any kind of Medicaid expansion or reform.

"You have to think about this as, what can we do in Missouri to improve, and reform, Medicaid going forward with this expansion, to make it better."

Tuesday afternoon, the governor also talked with Kathleen Sebelius, the U.S. Health and Human Services secretary and a former Kansas governor.

"The Secretary and I had a positive and productive conversation this afternoon about strengthening and reforming Medicaid," Nixon said, in a statement. "It is clear that moving forward and strengthening Medicaid will give us the flexibility we need to give Missourians the health system they deserve: one that protects taxpayers, rewards work, promotes personal responsibility and brings the tax dollars they send to Washington back here to Missouri."

The Senate's Appropriations Committee has begun its mark-up of the House-passed budget bills, and Medicaid expansion was not included in the House plans.

Nixon argues that blocking the expansion means "$300 for every man, woman and child that they'll pay in taxes in 2014" will be spent in other states.

The Legislature must complete its budget work by 6 p.m. on May 10.

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