In case there was any doubt, a coalition of Republicans made it clear Monday that they will do everything within their power to ensure there is no expansion of Medicaid eligibility this year in Missouri.
Five GOP senators took to the Senate floor as the Legislature returned from spring break to pronounce that they will block any attempt to expand Medicaid eligibility to lower-income adults during the annual session that ends in mid-May.
"This is done. It's not happening," said Sen. John Lamping, of St. Louis County, who said a coalition of Republicans would be willing to defeat or filibuster any attempts to expand Medicaid.
Added Sen. Brad Lager, of Savannah: "There is no path for Medicaid expansion to occur in Missouri this year."
Their strong pronouncements came a day before the House Government Oversight and Accountability Committee is to hear testimony on legislation that would expand Medicaid coverage to thousands of lower-income adults, partly by subsidizing their enrollment in private health insurance policies.
The House legislation would link the Medicaid expansion to a broader overhaul of the program. The legislation would enlarge the use of managed-care policies to cover children and parents and offer incentives for people to keep their health-care costs down. The bill is sponsored by seven of the 108 Republicans in the House, and it's unclear whether it ultimately will receive any debate by the full chamber.
A bill pending in the Senate would revamp Medicaid by requiring more people to be covered through managed-care insurance policies or coordinated-care associations created by health-care provides.
But the coalition of Republican senators said they would not stand for any amendments seeking to expanding eligibility for lower-income adults under the terms of President Barack Obama's health care law. About half of the states already have expanded eligibility and thus can receive billions of additional federal dollars.
Missouri's Republican-led Legislature has repeatedly defeated Medicaid expansion proposals over the past two years.
But Gov. Jay Nixon, his fellow Democrats in the Legislature and various health-care advocacy groups have continued to push for an expansion.
This year, the Missouri Chamber of Commerce and Industry hired former U.S. Sen. Kit Bond - one of Missouri's most prominent Republicans - to help lobby for an expansion of Medicaid eligibility in order to draw down the additional federal dollars. But that doesn't appear to have swayed some GOP lawmakers, who have continued to raise concerns that expanded Medicaid rolls could prove too costly for the state in the long-term.
"I'm one that's willing to stand as long as we need to, to make sure that it doesn't happen," Sen. Dan Brown, R-Rolla, said, a reference to a potential filibuster against a Medicaid expansion.
Republican Sens. Kurt Schaefer, of Columbia, and Ed Emery, of Lamar, also said Monday that they would help block any effort to expand Medicaid eligibility under the terms of the federal health care law.
Lamping said supporters of a Medicaid expansion should "go find something else to do."
"Go convince this current federal government to repeal Obamacare - you have a better chance of that happening than expanding Medicaid in Missouri," he said.