Gov. Jay Nixon wants to repair four of Missouri's seven veterans homes and build a new one.
He laid out that scenario Monday afternoon while addressing the Missouri Association of Veterans Organizations.
Missouri has more than 500,000 veterans, Nixon said, and for every one receiving care from a veterans home, there is another on a waiting list to get in - that means more than 1,900 veterans are waiting for admittance.
Veterans homes provide long-term medical care to elderly or disabled veterans qualifying for the services.
The governor plans to pay for the new home and the repairs with money raised by selling bonds.
Nixon's budget for the current fiscal year has $14.5 million in bond proceeds going to repair state buildings, including the Capitol complex, higher education building and the veterans homes.
The construction of a new home is estimated to cost around $50 million, and would be part of a bond issue for new construction, Nixon said.
The proposed repairs include renovating nurses stations, kitchens and restrooms in Cape Girardeau; improving the flooring and building new shower rooms in Mexico; replacing alarm systems, renovating the kitchen and the HVAC system, and adding a solarium in St. James; and renovating the entrance and lobby at the St. Louis home.
"State veterans homes played a vital role in caring for our veterans, and the services these homes provide are in great demand," Nixon said. "With our triple-A credit rating and low-interest rates, a bond issuance is a prudent, responsible way to make these needed improvements to our vets' homes."
As for the new home, the location has yet to be decided.
Nixon plans to consult with the Department of Public Safety and various veterans organizations to find determine the greatest need. There is no estimate on the time it will take to complete the project.
Nixon gave multiple reasons for using bonds to finance the projects, including low interest rates, recently granted legislative authority to expand bond capacity, and the $400 million in debt the state government recently paid off.
Before Nixon took the stage, state Sen. Ryan Silvey, R-Kansas City, explained his Veterans Family Health Care Act (Senate Bill 287).
He said the Legislature failure to expand Medicaid created a gap in health care coverage. Veterans make up about 13,000 of the Missourians in that gap.
"I don't like Obamacare, but the reality is we have a problem," Silvey told the MAVO audience. "We met with some veterans over the summer, and, for the first time, it became apparent to me that in this coverage gap there are veterans and there are, particularly, veterans' families - and that problem needs to be addressed."
He also explained his program would not use "Obamacare money" - the federal government's pledge in the Affordable Care Act to pay 90 percent of the increased costs for states that expand their Medicaid eligibility.
Instead, Silvey said, his program would have the state pay the larger, "normal" share of Medicaid costs - around 35 to 40 percent of the total - unless he could get a waiver of the Medicaid rules so the federal share would match 90 percent of the funds.
Nixon doubted that would be possible, stating the federal government is not likely to grant exceptions to expanding Medicaid for specific classes of people.
"The reality is we are locked in political debate, not a policy debate," Silvey said. "Obviously, if we did a solution for everybody in the gap, that would capture all the veterans and their families, and that would be great as far as I am concerned."
Nixon and Silvey agreed expanding Medicaid for everyone would solve the problem of uncovered veterans, but the "political" debate on the issue remains the strongest obstacle to Medicaid expansion.
"People need to get beyond the politics," Nixon said. "By taking health care away from 13,000 veterans that we pay taxes for, that have the right to get it, by taking away mental health coverage from 50,000 people, they are not hurting President Obama.
"They are hurting their constituents."