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Nixon adds new wrinkle to Medicaid expansion plan

With just three weeks remaining in the legislative session, Gov. Jay Nixon has added a new wrinkle to his proposal to tap into billions of federal Medicaid dollars to expand health coverage for lower income residents of Missouri.

The Democratic governor on Monday outlined an initiative dubbed “Missouri Health Works” that would use federal money to pay a portion of the private health insurance costs for businesses with fewer than 150 employees. The state aid would be available for people earning less than 138 percent of the poverty level, which is about $27,000 a year for a family of three.

But the plan faced immediate criticism in the Republican-led Legislature, which has repeatedly rejected attempts to expand Medicaid eligibility under the terms of President Barack Obama’s health care law. House Majority Leader John Diehl called Nixon’s proposal “a new gimmick.”

The legislative session ends May 16, and Republicans have no plans to approve a Medicaid expansion. The Senate reiterated that Monday by rejecting various Democratic budget amendments that would have depended on a Medicaid expansion.

Nixon said the Legislature’s inaction has made things worse for small business, which he said are “getting squeezed between sky-high health insurance costs and new requirements” under the federal health care law.

“I don’t expect the General Assembly to support Obamacare, but I do expect them to listen to small businesses and evaluate the situation on the merits, rather than the politics, to come up with a solution that’s right for the Show Me State,” Nixon said during a Monday news conference in Cape Girardeau covered by the Southeast Missourian newspaper. “Simply put, there are no more excuses for inaction.”

Nixon announced the proposal at the Cape Girardeau Chamber of Commerce.

But it came as a surprise to Dan Mehan, president and CEO of the Missouri Chamber of Commerce and Industry, which has been lobbying lawmakers in favor of a revamped Medicaid program that would use additional federal dollars to expand coverage. Mehan said Medicaid expansion is essentially dead in the Legislature this year and expressed frustration that the governor waited until the end of the session to roll out the proposal.

“If he were serious about this he wouldn’t wait until there’s three weeks left in session, and he would maybe try to engage members of the General Assembly before spending state money on the airplane flying down to Cape Girardeau to talk about it,” said Diehl, R-Town and Country.

House Speaker Tim Jones, who was in Cape Girardeau for a separate news conference Monday about tax cuts, also criticized Nixon for not bringing the plan to lawmakers sooner.

Under the federal health care law, states that expand adult Medicaid eligibility to 138 percent of the poverty level can initially receive full federal funding for those added to the rolls. The federal aid for the expanded pool of people would gradually be reduced to a 90 percent share, which is still significantly higher than the federal percentage of the tab for the rest of the Medicaid program.

But some Republican lawmakers have raised concerns about Missouri’s eventual share of the costs of a Medicaid expansion.

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