Missouri health care advocates praised a U.S. Supreme Court ruling Thursday that backs nationwide subsidies under President Barack Obama's health care overhaul, while Republican leaders continued to call the health care law flawed and renewed calls to ax it.
Thursday's 6-3 ruling means roughly 200,000 Missourians will continue to receive tax credits to offset the cost of their insurance coverage.
"These Missourians will not have to choose between health insurance and other basic needs," said Ryan Barker, Missouri Foundation for Health policy director.
Missouri is one of 34 states using the federal health care exchange - a federally-run website where residents can buy health insurance. People can qualify for tax credits to subsidize their insurance costs.
Missouri's GOP members of Congress generally expressed disappointment in the decision.
"Obamacare has been a disaster since its inception. This ruling does nothing to help the American people get out from underneath the clutch of an onerous federal mandate and bolsters a bad law, making it more difficult for Congress to work towards real, patient-centered reform to our broken health care system," U.S. Rep. Vicky Hartzler, R-Harrisonville, said.
U.S. Sen. Roy Blunt said: "For more than five years, I've heard from countless Missouri workers, seniors and families who are facing higher costs and fewer choices due to the president's health care takeover. And Missourians recently learned more bad news when the Obama Administration announced premium rate increases for our state in 2016 of up to 34 percent."
Blunt said he'll fight to replace the current "flawed" program "with a patient-centered system that lowers costs, increases choices, and provides greater access to quality care."
U.S. Rep. Blaine Luetkemeyer, R-St. Elizabeth, added: "While I had hoped for a different outcome, this does not mean that I will give up the fight to chip away at the costly and job killing components of the president's failed health care law."
But Democratic leaders joined advocates in expressing relief for keeping the status quo, while also arguing state lawmakers must expand Medicaid eligibility for low-income adults as another way to increase access to health insurance.
Missourians above the poverty level can qualify for subsidies through the federally-run insurance exchange. Medicaid is intended to cover health care for the country's poorest residents. To be eligible for Medicaid in Missouri, an adult must earn less than 19 percent of the federal poverty level.
Under the terms of the federal health care law, states can receive enhanced federal funding if they raise eligibility for adults earning up to 138 percent of the federal poverty level.
"(The) ruling by the Roberts court to uphold the Affordable Care Act a second time removes all doubt that the ACA is and will remain the law of the land," Democratic Gov. Jay Nixon said in a statement. "There are no more excuses for ... denying 300,000 working Missourians the opportunity to access affordable health care coverage through Medicaid expansion."
Attorney General Chris Koster - who wants to succeed Nixon as governor - said in a statement from his campaign: "Republicans and Democrats both agree that America's health care system has long needed to change. ...
"The subsidies are an important part of building our health care infrastructure and providing affordable care to low- and middle-income families. I hope our state legislature will now see the economic value in Medicaid expansion and bring Missouri's tax dollars back to our state."
The Legislature's Republican leaders repeatedly have said Medicaid expansion was a non-starter, because the plan can't be sustained financially.
U.S. Sen. Claire McCaskill, a Democrat, didn't issue a formal comment Thursday, but said on Twitter: "Supreme Court decision on health care law (equals) common sense. Time for (Republicans) to stop the bashing and start working (with) us to make it better."