The halfway point of Missouri's legislative session is too early to call the outcome of a proposal to expand Medicaid.
Democratic Gov. Jay Nixon has championed a plan to add about 300,000 additional Missourians to Medicaid - to be funded by the federal government for the first three years as part of the Affordable Care Act. The state's Medicaid program, funded by state and federal dollars, now provides health care to about 900,000 low-income Missourians.
Part of Nixon's argument is the federal money will be spent, and Missouri should make sure that its share is spent here, not somewhere else.
Republican majorities in both chambers, however, repeatedly have rejected Medicaid expansion. They consider the federal government an unreliable partner regarding both policy and funding. They point out nearly half of the state's general revenue now is spent on Medicaid, and they fear future consequences when the federal government's three-year commitment ends.
We share that fear and commend their foresight.
Government must look ahead and plan for the long term, particularly when an ebb in future funding is a given, not a guess.
Supporters of Medicaid expansion focus on the here and now. The proposal is being touted not only as a health program, but as a jobs program and economic development program.
Proponents contend the proposal will create up to 24,000 jobs; they say failure to approve the expansion will increase uncompensated health care costs by $11.1 billion and impose a "hidden health care tax" increase on businesses and families.
The stakes in this debate, obviously, are high.
But the debate need not be an either/or proposition.
As spring break began, the Senate's majority caucus said it "will continue to review and discuss any and all responsible proposals," including the possibility of "block grants issued to the state to develop its own plan."
And, in the House, Republican Rep. Jay Barnes of Jefferson City has crafted a "Medicaid Transformation" bill to be discussed after lawmakers return on Monday.
Chasing the federal carrot being dangled in front of lawmakers would mean short-term gain and long-term pain.
We encourage lawmakers to work toward creating a viable Medicaid program for today and for the future.