Editor's note: This article expands upon the original report posted on Tuesday, Dec. 31, 2013.
Gov. Jay Nixon said Tuesday that Missouri's failure to expand or reform Medicaid during the 2013 legislative session will "make standing still feel like moving backwards."
"The differentials of not moving forward will be seen out there-rising premiums and a lack of access to health care," Nixon said. "Those things are more dramatic than our neighboring states who are moving forward."
Medicaid is health insurance administered by states for free or at low-cost to low-income individuals who meet specific requirements.
Twenty-five states decided to reform and improve their health care systems by expanding Medicaid through Obamacare. The federal government pays 100 percent of expansion costs the first three years and 90 percent of costs the years after until 2022.
Missouri decided to opt out of Medicaid expansion for 2014.
"Tomorrow, roughly $37 billion-including $2 billion of Missourians' tax dollars-will begin to flow to 25 states that are reforming and improving their health care systems," Nixon said Tuesday. "States like Arkansas and New Jersey, Iowa and New Mexico, Michigan and Ohio, Arizona and North Dakota."
The "tomorrow" Nixon is referring to, was Jan. 1, the day that more than 2 million Americans received health coverage through the federal Health Insurance Marketplace, state-run marketplaces and expanded Medicaid programs. Coverage for those who enrolled at healthcare.gov before or on Dec. 24 began that day.
Missouri's failure to expand Medicaid, excludes nearly 300,000 Missourians from being added to the state's Medicaid rolls for 2014.
Nixon said those 300,000 Missourians are "factory workers and house cleaners, mechanics and truck drivers, moms and dads."
"These folks work tough, low-paying jobs that don't offer health benefits, and they can't afford a doctor's bill," he said.
He said the legislature's failure to expand Medicaid not only affects working Missourians, but also Missouri businesses.
"Tomorrow, employers in Missouri will face an uneven playing field-shouldering the burden of rising health premiums, while their competitors in other states see their costs go down," Nixon said.
Missouri Medicaid in 2014
Nixon said three things have changed since the 2013 legislative session that make it likely the state legislature will pass some sort of Medicaid reform in 2014.
"First of all, the interim committees have heard a lot from Missourians this summer," Nixon said. "They heard Missourians from all corners of our state say moving forward is the right thing to do."
Secondly, he said Missouri has seen other states move forward and get needed reforms.
He said the third change is that now Missouri tax dollars are being used on various reform measures in other states-those that decided to expand Medicaid.
"My sense, is that that's just not the way we like to do things in our state," Nixon said. "We take care of our tax dollars, we like to spend those tax dollars smartly."
Nixon pushed for Medicaid expansion during the 2013 legislative session, but was met with opposition from Republican lawmakers.
A Democrat-sponsored House bill detailing Medicaid expansion failed to make it out of House committee hearings, as did a Republican-sponsored Medicaid reform bill.
This past summer, interim legislative committees toured the state seeking input from Missourians. Several bills related to Medicaid have been prefiled in Missouri's House of Representatives and Senate for the legislative session that begins Jan. 8.
Nixon said he's appreciative of the work lawmakers are putting in on Medicaid reform.
He believes that when considering reform, it's important to protect taxpayers, to demand personal responsibility, to increase the efficiency and effectiveness of the state's health care system, and to improve Missourians' overall access to care.
He said the biggest difference regarding Medicaid and 2014's legislative session is that the issue is no longer theoretical.
"What I know right now is that numerous people across the country who are working will wake up tomorrow and have the benefit of health care with reforms," Nixon said. "I think it's real right now."